Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare

Objective: To analyse a prediction model for admissions and hospital emergencies based on Clinical Risk Groups, in a population of complex chronic patients demanding primary care. Design: A multicentric retrospective observational study, of a cohort of chronic patients with comorbidity, from January...

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Authors: Sánchez Molla M, Candela García I, Orozco-Beltrán D, Gil-Guillén VF, Carratalá-Munuera C, García RN
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16278
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/16278
Access Level:Open access
Keyword:Hospital emergencies
Hospital admission
Clinical risk groups
Chronic patients
Multipathological patient
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spelling Predictive validity of Clinical Risk Groups in chronic patients in primary healthcareSánchez Molla MCandela García IOrozco-Beltrán DGil-Guillén VFCarratalá-Munuera CGarcía RNHospital emergenciesHospital admissionClinical risk groupsChronic patientsMultipathological patientObjective: To analyse a prediction model for admissions and hospital emergencies based on Clinical Risk Groups, in a population of complex chronic patients demanding primary care. Design: A multicentric retrospective observational study, of a cohort of chronic patients with comorbidity, from January until December 2013. Place: The study population was assigned to the Santa Pola and Raval health centres from the Health Department of Elche. Participants: Cohort of chronic patients with comorbidity, from January to December 2013. Interventions: Data about the number of admissions, reasons and complexity level associated with the admission were collected by the review of medical records. Main measures: To determine the level of complexity, the classification included in the chronicity strategy of the Valencian Community based on Clinical Risk Groups was used. Results: Five hundred and four patients were recruited with a high complexity degree (N3) and 272 with moderate/low complexity (N1-N2). A higher comorbidity was observed in N3 patients with high complexity [Charlson 2.9 (DE 1.8) vs. 1.9 (DE 1.3); P<.001], and higher dependence degree for basic diary activities [Barthel 16.1 (n = 81) vs. 7.3 (n = 20); P<.001]. Association between the number of admissions [0.4 (DE 0.8) vs. 0.1 (DE 0.5); P<.001] and emergency visits [0.8 (DE 1.5) vs. 0.3 (DE 0.8), P<.001] was significatively higher in patients from N3 group than N1-N2 groups. Conclusions: The predictive capacity of CRG grouper showed high sensibility for the patient classification with a high degree of complexity. Its specificity and positive predictive value were lower for the association of the N3 complexity stratum. (c) 2023 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).EDICIONES DOYMA S A2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16278Atencion PrimariaISSN: 02126567ISSNe: 15781275reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Españolinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p162782026-06-11T12:45:17Z
dc.title.none.fl_str_mv Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
title Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
spellingShingle Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
Sánchez Molla M
Hospital emergencies
Hospital admission
Clinical risk groups
Chronic patients
Multipathological patient
title_short Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
title_full Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
title_fullStr Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
title_full_unstemmed Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
title_sort Predictive validity of Clinical Risk Groups in chronic patients in primary healthcare
dc.creator.none.fl_str_mv Sánchez Molla M
Candela García I
Orozco-Beltrán D
Gil-Guillén VF
Carratalá-Munuera C
García RN
author Sánchez Molla M
author_facet Sánchez Molla M
Candela García I
Orozco-Beltrán D
Gil-Guillén VF
Carratalá-Munuera C
García RN
author_role author
author2 Candela García I
Orozco-Beltrán D
Gil-Guillén VF
Carratalá-Munuera C
García RN
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Hospital emergencies
Hospital admission
Clinical risk groups
Chronic patients
Multipathological patient
topic Hospital emergencies
Hospital admission
Clinical risk groups
Chronic patients
Multipathological patient
description Objective: To analyse a prediction model for admissions and hospital emergencies based on Clinical Risk Groups, in a population of complex chronic patients demanding primary care. Design: A multicentric retrospective observational study, of a cohort of chronic patients with comorbidity, from January until December 2013. Place: The study population was assigned to the Santa Pola and Raval health centres from the Health Department of Elche. Participants: Cohort of chronic patients with comorbidity, from January to December 2013. Interventions: Data about the number of admissions, reasons and complexity level associated with the admission were collected by the review of medical records. Main measures: To determine the level of complexity, the classification included in the chronicity strategy of the Valencian Community based on Clinical Risk Groups was used. Results: Five hundred and four patients were recruited with a high complexity degree (N3) and 272 with moderate/low complexity (N1-N2). A higher comorbidity was observed in N3 patients with high complexity [Charlson 2.9 (DE 1.8) vs. 1.9 (DE 1.3); P<.001], and higher dependence degree for basic diary activities [Barthel 16.1 (n = 81) vs. 7.3 (n = 20); P<.001]. Association between the number of admissions [0.4 (DE 0.8) vs. 0.1 (DE 0.5); P<.001] and emergency visits [0.8 (DE 1.5) vs. 0.3 (DE 0.8), P<.001] was significatively higher in patients from N3 group than N1-N2 groups. Conclusions: The predictive capacity of CRG grouper showed high sensibility for the patient classification with a high degree of complexity. Its specificity and positive predictive value were lower for the association of the N3 complexity stratum. (c) 2023 The Authors. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16278
url https://fisabio.portalinvestigacion.com/publicaciones/16278
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv EDICIONES DOYMA S A
publisher.none.fl_str_mv EDICIONES DOYMA S A
dc.source.none.fl_str_mv Atencion Primaria
ISSN: 02126567
ISSNe: 15781275
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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