ICCONIC findings featured in a Guardian article.

Although there are cross-country differences in the availability and structure of data sources, countries had the ability to effectively identify comparable HNHC personas for international study. This work serves as the methodological paper for six accompanying papers examining differences in spending, utilization, and outcomes for these personas across countries.

Health systems across high-income countries have similar goals, which include maximizing quality of care, offering services responsive to patient needs, and ensuring efficient health care delivery. Health systems also face similar challenges, such as changing demographics, limited national resources, and ongoing rising health care costs.3 In response, national policy makers are working to identify effective strategies to address these challenges, which are heavily influenced by existing health system features. A group of particular concern is the growing number of high-need, high-cost (HNHC) patients, a clinically diverse set of patients with multiple medical needs, frailty, and multimorbidity. While constituting a relatively small proportion of the population, these patients account for a disproportionate share of medical expenditures across health systems.

Report of ICCONIC research to the Health Foundation.

ICCONIC work featured in a CMWF To The Point blog.

Across seven countries, we find important variations in end-of-life care for patients who sustained a hip fracture, with some differences explained by sex and age. Our work sheds important insights that may help ongoing health policy discussions on equity, efficiency, and reimbursement in health care systems.

Distribution of health care consumption in different settings varies within countries, but there are also some common treatment patterns across all countries. Clinicians and policy makers need to look into these differences in care utilization by sex and care setting to determine whether they are justified or indicate suboptimal care.

Across 11 countries, there are meaningful differences in health system outcomes for two types of patients.

In this comparison of LTC services following a hip fracture, we found international differences in total use of institutional and noninstitutional care, longevity, and total expenditures. There exist opportunities to organize postacute care differently to maximize independence and mitigate costs.

Across 11 countries, there is substantial variation in health care spending and utilization for a complex multimorbid persona with heart failure and diabetes. Drivers of spending vary across countries, with the United States being the most expensive country due to high prices and higher use of facility-based rehabilitative care.