Predictive risk and health care: an overview – Nuffield Trust – 2 March 2011

Posted on March 18, 2011. Filed under: Health Economics | Tags: , |

Predictive risk and health care: an overview – Nuffield Trust – 2 March 2011

Author: Dr Martin Bardsley and others

“Predictive risk adjustment tools are becoming increasingly important in the NHS, with primary care trusts (PCTs) and GP consortia expected to make greater use of such tools to stratify the health risk of the populations they serve.

These tools use relationships in historic, routinely collected electronic health data to determine the expected future health care resource use of each individual in a population. The tools can be used to estimate future events for people at different levels of risk, providing commissioners with more accurate estimates of likely future costs.

In the US and Europe, risk adjustment models are used widely to help determine health payments, either for fixing ‘capitated’ budgets or for deciding reimbursement rates for individual patients. In the NHS, the most widespread use of these techniques so far has been in the use of ‘case finding’ tools, such as the Patients At Risk of Re-hospitalisation (PARR) and the ’Combined Model’.

Predictive risk and health care: an overview explores how predictive risk adjustment techniques are currently being used in the NHS and identifies some of the challenges involved in applying the techniques in practice. The research summary also looks at emerging developments, including modelling with social care data, predicting the impact of preventive care and making shorter-term predictions of readmissions.”

…continues on the site

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