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Special Issue: International Comparisons of High-Need, High-Cost Patients: New Directions in Research and Policy

Health Services Research (HSR) and the International Collaborative on Costs, Outcomes and Needs In Care (ICCONIC) are partnering to publish a Special Issue on International Comparisons of High-Need, High-Cost Patients: New Directions in Research and Policy.

Sponsored by: The Health Foundation

Submission deadline: November 30, 2020

Health systems around the world have similar goals: maximizing quality of care for their populations, offering services that are responsive to patient needs and providing value for money. International comparisons can be a useful tool to provide national policy makers and clinical leaders with a benchmark that helps determine whether countries are achieving their goals. However, due to the inherent gaps in data, underdeveloped analytic methodologies and lack of consideration of key structural differences across health systems, poor comparisons can lead to unwarranted policy interpretations with adverse consequences for policy makers. Properly conducted cross-national comparisons can provide a rich source of data to learn from and inform health policy.

One key challenge facing many health systems is how to best design services to provide care to a small number of high-need, high-cost individuals. These patients are expensive and often the most vulnerable to experiencing the ill effects of poor quality care. In recent years, policy makers and clinical leaders have increased their efforts to understand how best to care for this heterogeneous group of patients with a diverse set of needs stemming from multiple physical conditions, mental and behavioural health issues and complex social problems. However, despite the enormous importance of this population, there are limited data on how different nations and health systems manage these patients.

Therefore, the goal of this Special Issue is to highlight cutting-edge work that showcase the potential to learn from international comparisons of high-need, high-cost individuals. A portion of the Special Issue will feature the work of the International Collaborative on Costs, Outcomes and Needs in Care (ICCONIC). ICCONIC consists of 12 partners from North America, Europe and the Pacific who use national and regional patient-level datasets to explore variations in the utilization and costs of health services for particular types of high-need individuals. The rest of the Special Issue will consist of invited submissions that examine areas related to the delivery of care for high-need, high cost-individuals.

Illustrative examples of topics within the area include but are not limited to:

  1. Outline the strengths and weaknesses of different methodological approaches to identify high-need, high-cost patients across countries using patient-level national and regional datasets
  2. The examination of the key patient characteristics of specific high-need, high-cost patients across different countries
  3. Detailed exploration of variations in healthcare spending and utilization across the entire care pathway for specific high-need patients, including primary care, outpatient specialty care, hospital care, post-acute care and pharmaceuticals
  4. Detailed exploration of differences in key patient outcomes for specific patient populations across countries

We strongly encourage cutting-edge research that opens up new frontiers in the study of high-need, high-cost patients and that delineates key questions that can be addressed in future investigation. Papers that offer a comparative perspective from more than one health system will be prioritized. Papers that are opinion pieces or reviews will not be considered. While the issue may include a framework/review paper and/or a summary/commentary, these will be solicited separately.

The deadline for initial submission of abstracts is November 30, 2020. Abstracts may not exceed 300 words and must otherwise be formatted as indicated in the “Instructions for Authors” here. These abstracts will be evaluated by a multidisciplinary review panel that will select the best abstracts to receive invitations to submit full manuscripts. The evaluation criteria will include: (1) quality, rigor and originality; (2) significance and usefulness for furthering our understanding of how to improve the care for high-need, high-cost patients across health systems; and (3) clarity of writing and presentation.

Manuscripts submitted for the Special Issue will first undergo the same HSR peer review process as all regular manuscripts. However, due to the timeline for publishing the Special Issue, HSR will monitor the progress of manuscripts through the review process to shorten the overall review process. Likewise, authors should expect to be especially prompt in returning requested revisions. Approximately 6 to 8 articles will be selected, based on the most original and significant work addressing the topic of comparative health systems. The print publication date for the Special Issue will be December 2021.

Key dates proposed:

  • November 30, 2020: Submission deadline for abstracts for the Special Issue.
  • December 21, 2020: Notification sent to authors of manuscript invitation for Special Issue.
  • March 1, 2021: Submission deadline of manuscripts for the Special Issue.
  • October 1 2021: Notification of assignment of accepted manuscripts to the Special Issue.
  • December, 2021: Print Publication Date for Special Issue.

If you would like to submit your abstract for consideration, please email your abstract and co-author contact information to the editorial office at hsr@aha.org, including “Special Issue on High-Need, High-Cost Patients” in the subject line.