Blog Post

How England's complex care hub cut length of stay by 46%

August 23, 2017

    This is the first blog in a series about care transformation around the globe, where we look at successful population health managers outside the United States. In this post, we highlight the successes of the Symphony Programme, a UK population health management initiative.

    Increasingly limited resources and sicker patients have spurred health care innovation and integration across the globe. Countries like Australia, the United Kingdom, Germany, Spain, and the Netherlands are all building upon the successes of early adopters. Throughout 2017, we'll be sharing their stories and lessons for care transformation from international population health managers.

    Our first case takes us to the Somerset region of England. In 2011, the local health payer commissioned an extensive analysis to determine which groups of patients were most costly to the system and would benefit from better coordinated care. A local university analyzed a year's worth of anonymized data from 115,000 patients, specifically with the goal of understanding how these patients were using health and social care.

    What they found surprised them. The researchers expected to see that costs were primarily associated with age—with older people experiencing higher costs. Instead, they found that costs were explained more by a patient's number of chronic comorbidities.

    Researchers then used cost data to identify the most expensive combinations of specific chronic conditions. Using analyses like the spider web graphic below, the researchers ultimately determined that costs were driven as much by patients' number of comorbidities as by their type of comorbidities. For example, they found that those with hypertension and more than three chronic conditions accrued the highest cost, where as those with asthma and no chronic conditions accrued the lowest cost.

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