Our team has shown that patients with multiple chronic illnesses, that is, with a high burden of comorbidity, are driving a significant portion of health care costs. In our studies, a comorbidity index which assigns weights to specific chronic diseases was used to assess the burden of comorbid disease.
Reducing Costs in Patients with High Comorbidity
Dr. Charlson is developing a project to develop and validate models of the drivers of cost variability among patients with a high burden of comorbidity in order to identify patients most likely to benefit from a medical home. We will evaluate a total of 15,000 patients with different burdens of comorbidity who have at least two continuous years of enrollment in the Generations+/Northern Manhattan Health Network (Gen+), a member of the NYC Health and Hospitals Corporation. The project will evaluate the predictors of cost variability in patients with a comorbidity score of three or more through a telephone survey of approximately 1000 patients. The project will document demographic, clinical psychosocial, behavioral, and functional determinants of cost variability.