High-need high-cost patients: A Concept Analysis.
High-need high-cost (HNHC) patients are variously defined in the literature as the small subset of the population who account for the majority of US health care costs. Lack of consensus on the defining attributes of HNHC patients has challenged the effectiveness of interventions aimed to improve disease management and reduce costs. Guided by the Walker and Avant method of concept analysis, a literature review of 2 databases (PubMed and CINAHL) was conducted. Three main subgroups of HNHC patients were identified: adults with multiple chronic conditions and functional disability, the frail elderly, and patients under 65 years old with a disability or behavioral health condition. HNHC patients are categorized by a feedback loop of acute-on-chronic health conditions, preventable health service utilization, and fragmented care. Antecedents that predispose becoming a HNHC patient include challenges accessing timely care, low socioeconomic status, unmet support, and social factors such as isolation and inadequate.
['Bilazarian|Ani|A|http://orcid.org/0000-0002-7095-5369']
D003210:Concept Formation D019468:Disease Management D017048:Health Care Costs D006801:Humans D020380:Needs Assessment D062072:Patient Acuity
chronic disease management health promotion policy/politics public health