Research in Complex Patients and Health System

Description

Various socioeconomic, demographic and sanitary circumstances have consolidated the phenomenon known as epidemiological transition. This explains the increasing prevalence of concurrence of several chronic processes in a same person, a factor known as comorbidity or multimorbidity. These patients use a great amount of resources, and their characteristics lead to numerous difficulties in their clinical management because of which they tend to be considered fragile or complex patients. As a result, they represent a clear challenge for healthcare services. Specific strategies to prevent chronicity have consequently been implemented at both a ministerial and autonomic level.

This scenario gives rise to the need to conduct specific research with this type of patients based on the different parameters that affect them. Our research group is consequently multiprofessional and comprised by all professionals involved in some way in the medical care of this group of patients (family doctors, nurses, pharmacists, social workers, IT specialists, etc.).

Lines of work

• Epidemiology and chronicity (multimorbidity and comorbidity). Comorbidity patterns in chronic diseases.
• Study on the dynamics of the Primary Care – Specialized Care Interface in the medical care and clinical management of complex patients.
• Development of Information Systems and administrative clinical databases for the study of chronicity.
• Assessment of the Patient Classification and Stratification System and of the Casuistic Adjustment System (case-mix).
• Evaluation of alternatives and new approaches in the management of complex patients (sociosanitary, telemedicine, etc.).
• Quantification of the impact of this group of patients on the healthcare service (use of services and costs), seeking their efficient management.
• Analyzing the results obtained in the medical care of this group of patients:
  • Polypharmacy and Adverse Drug Reactions
  • Avoidable hospitalizations (Ambulatory Care Sensitive Conditions [ACSC])
  • Mortality and Analysis of Survival Rates
• Effectiveness and efficiency studies concerning the clinical management of this type of patients.