{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:16:05Z","timestamp":1792592165063,"version":"4.5.0"},"reference-count":68,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. (1) Assessing the performance of the algorithm in terms of sensitivity and positive predictive value, considering General Practitioners\u2019 (GPs) judgement as benchmark, and (2) describing adverse events (hospitalisation, death, and health services\u2019 consumption) of complex patients compared to the general population.<jats:italic> Data Sources<\/jats:italic>. (i) Tuscany administrative database containing health data (2013-5); (ii) lists of complex patients indicated by GPs; and (iii) annual health registry of Tuscany.<jats:italic> Study Design<\/jats:italic>. The present study is a validation study. It compares a list of complex patients extracted through an administrative algorithm (criteria of high health consumption) to a gold standard list of patients indicated by GPs. GPs\u2019 decision was subjective but fairly well reasoned. The study compares also adverse outcomes (Emergency Room visits, hospitalisation, and death) between identified complex patients and general population.<jats:italic> Principal Findings<\/jats:italic>. Considering GPs\u2019 judgement, the algorithm showed a sensitivity of 72.8% and a positive predictive value of 64.4%. The complex cases presented here have higher incidence rates\/100,000 (death 46.8; ER visits 223.2, hospitalisations 110.87, laboratory tests 1284.01, and specialist examinations 870.37) compared to the general population.<jats:italic> Conclusions<\/jats:italic>. The final validated algorithm showed acceptable sensitivity and positive predictive value.<\/jats:p>","DOI":"10.1155\/2017\/9569348","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T17:09:52Z","timestamp":1499706592000},"page":"1-12","source":"Crossref","is-referenced-by-count":4,"title":["Identifying High-Cost, High-Risk Patients Using Administrative Databases in Tuscany, Italy"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4962-8312","authenticated-orcid":true,"given":"Irene","family":"Bellini","sequence":"first","affiliation":[{"name":"Medical School of Hygiene and Preventive Medicine, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Barletta","sequence":"additional","affiliation":[{"name":"Agenzia Regionale Sanit\u00e0, Tuscany, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Profili","sequence":"additional","affiliation":[{"name":"Agenzia Regionale Sanit\u00e0, Tuscany, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bussotti","sequence":"additional","affiliation":[{"name":"Health Care Continuity Unit, University Hospital of Careggi, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Severi","sequence":"additional","affiliation":[{"name":"Local Health Authorities of Central Tuscany, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Isoldi","sequence":"additional","affiliation":[{"name":"Local Health Authorities of Central Tuscany, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bimbi","sequence":"additional","affiliation":[{"name":"Local Health Authorities of Central Tuscany, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Francesconi","sequence":"additional","affiliation":[{"name":"Agenzia Regionale Sanit\u00e0, Tuscany, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"2","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2011.0026"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-70"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2009.01080.x"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0041"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0307-0"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.5334\/ijic.256"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.15256\/joc.2012.2.15"},{"issue":"12, article 152","key":"15","first-page":"797","volume":"157","year":"2012","journal-title":"Annals of Internal Medicine"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1840"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1037\/a0018048"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000045"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00401.x"},{"issue":"12","key":"20","first-page":"1655","volume":"54","year":"2008","journal-title":"Canadian Family Physician"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.3.m255"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-004-0616-2"},{"key":"23","volume":"2, article 47","year":"2004","journal-title":"Health and quality of life outcomes"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31818bf574"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2009.10.006"},{"issue":"7","key":"26","first-page":"e253","volume":"57","year":"2011","journal-title":"Canadian Family Physician"},{"key":"27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.6.716"},{"key":"28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.09.009"},{"key":"29","doi-asserted-by":"publisher","DOI":"10.1353\/pbm.2005.0098"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.1370\/afm.272"},{"key":"31","first-page":"244","volume":"51","year":"2005","journal-title":"Canadian Family Physician"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-2-51"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39201.463819.2C"},{"key":"34","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-8-14"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmp020"},{"key":"36","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318030fff9"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11x548929"},{"key":"38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015941"},{"key":"39","year":"2007","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"40","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-9-6"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1080\/13814780802436093"},{"issue":"7604, article 1128","key":"42","volume":"334","year":"2007","journal-title":"BMJ"},{"key":"43","doi-asserted-by":"publisher","DOI":"10.1016\/s0895-4356(97)00306-5"},{"key":"50","doi-asserted-by":"publisher","DOI":"10.1258\/135581903322403281"},{"key":"44","doi-asserted-by":"publisher","DOI":"10.1056\/nejmsb042458"},{"key":"45","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0308-z"},{"key":"46","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2004.09.004"},{"key":"47","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61415-9"},{"key":"48","doi-asserted-by":"publisher","DOI":"10.1370\/afm.528"},{"key":"49","doi-asserted-by":"publisher","DOI":"10.2190\/41x8-42qw-2571-h20g"},{"key":"51","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/57.8.M523"},{"key":"52","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(03)00084-6"},{"key":"53","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.53.7.861"},{"key":"54","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.06.052"},{"key":"55","volume-title":"Supporting informal caregivers: the heart of home care","year":"2010"},{"key":"56","doi-asserted-by":"publisher","DOI":"10.1080\/073993399245656"},{"key":"57","doi-asserted-by":"publisher","DOI":"10.1177\/1742395310383338"},{"key":"58","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2004.00312.x"},{"key":"59","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-9824.2010.01063.x"},{"key":"60","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmn040"},{"key":"61","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0316-z"},{"key":"62","year":"2004"},{"key":"64","year":"2002"},{"key":"66","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2010.04.017"},{"key":"67","doi-asserted-by":"publisher","DOI":"10.1007\/s11414-008-9120-8"},{"key":"68","doi-asserted-by":"publisher","DOI":"10.1370\/afm.983"},{"key":"69","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmm049"},{"key":"70","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/62.3.296"},{"key":"71","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(99)00408-6"},{"key":"72","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.0.0115"},{"key":"73","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2007.05.002"},{"issue":"2","key":"74","first-page":"62","volume":"53","year":"1998","journal-title":"Geriatrics"},{"key":"75","doi-asserted-by":"publisher","DOI":"10.1370\/afm.778"},{"issue":"1, article a13","key":"76","volume":"7","year":"2010","journal-title":"Preventing Chronic Disease"},{"key":"78","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2007.11.002"}],"container-title":["BioMed Research International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2017\/9569348.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2017\/9569348.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/bmri\/2017\/9569348.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T17:09:54Z","timestamp":1499706594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/bmri\/2017\/9569348\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":68,"alternative-id":["9569348","9569348"],"URL":"https:\/\/doi.org\/10.1155\/2017\/9569348","relation":{},"ISSN":["2314-6133","2314-6141"],"issn-type":[{"value":"2314-6133","type":"print"},{"value":"2314-6141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017]]}}}