TY - JOUR
T1 - Introducing the Adults with Chronic Healthcare Needs (ACHCN) definition and screening instrument
T2 - Rationale, supporting evidence and testing
AU - Gulley, Stephen P.
AU - Rasch, Elizabeth K.
AU - Altman, Barbara M.
AU - Bethell, Christina D.
AU - Carle, Adam C.
AU - Druss, Benjamin G.
AU - Houtrow, Amy J.
AU - Reichard, Amanda
AU - Chan, Leighton
N1 - Funding Information:
This research was supported by the NIH Intramural Research Program . The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the National Institutes of Health, the United States government or the other institutions with which the authors are affiliated. The authors gratefully acknowledge the contributions of the other members of the ACHCN expert panel, including: Stephen Blumberg, Ph.D., (CDC/NCHS) and Margaret Grace Stineman, MD, (Perelman School of Medicine, University of Pennsylvania).
Funding Information:
This research was supported by the NIH Intramural Research Program. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the National Institutes of Health, the United States government or the other institutions with which the authors are affiliated. The authors gratefully acknowledge the contributions of the other members of the ACHCN expert panel, including: Stephen Blumberg, Ph.D., (CDC/NCHS) and Margaret Grace Stineman, MD, (Perelman School of Medicine, University of Pennsylvania).
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Background: Among working age adults in the United States, there is a large, heterogeneous population that requires ongoing and elevated levels of healthcare and related services. At present, there are conflicting approaches to the definition and measurement of this population in health services research. Objective: An expert panel was convened by the National Institutes of Health with the objective of developing a population-level definition of Adults with Chronic Healthcare Needs (ACHCN). In addition, the panel developed a screening instrument and methods for its use in health surveys to identify and stratify the population consistently. Methods: The panel employed multiple methods over the course of the project, including scoping literature reviews, quantitative analyses from national data sources and cognitive testing. Results: The panel defined the ACHCN population as “Adults (age 18–65) with [1] ongoing physical, cognitive, or mental health conditions or difficulties functioning who [2] need health or related support services of a type or amount beyond that needed by adults of the same sex and similar age.” The screener collects information on chronic health conditions, functional difficulties, and elevated use of or unmet need for healthcare services. Conclusions: Adapted from the Maternal and Child Health Bureau definition that identifies Children with Special Healthcare Needs, aligned with the ACS-6 disability measure, and consistent with the HHS Multiple Chronic Condition Framework, this definition and screener provide the research community with a common denominator for the identification of ACHCN.
AB - Background: Among working age adults in the United States, there is a large, heterogeneous population that requires ongoing and elevated levels of healthcare and related services. At present, there are conflicting approaches to the definition and measurement of this population in health services research. Objective: An expert panel was convened by the National Institutes of Health with the objective of developing a population-level definition of Adults with Chronic Healthcare Needs (ACHCN). In addition, the panel developed a screening instrument and methods for its use in health surveys to identify and stratify the population consistently. Methods: The panel employed multiple methods over the course of the project, including scoping literature reviews, quantitative analyses from national data sources and cognitive testing. Results: The panel defined the ACHCN population as “Adults (age 18–65) with [1] ongoing physical, cognitive, or mental health conditions or difficulties functioning who [2] need health or related support services of a type or amount beyond that needed by adults of the same sex and similar age.” The screener collects information on chronic health conditions, functional difficulties, and elevated use of or unmet need for healthcare services. Conclusions: Adapted from the Maternal and Child Health Bureau definition that identifies Children with Special Healthcare Needs, aligned with the ACS-6 disability measure, and consistent with the HHS Multiple Chronic Condition Framework, this definition and screener provide the research community with a common denominator for the identification of ACHCN.
KW - Chronic conditions
KW - Health service utilization
KW - Health surveys
KW - Measurement
KW - People with disabilities
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U2 - 10.1016/j.dhjo.2017.08.003
DO - 10.1016/j.dhjo.2017.08.003
M3 - Article
C2 - 28823389
AN - SCOPUS:85027440804
SN - 1936-6574
VL - 11
SP - 204
EP - 213
JO - Disability and Health Journal
JF - Disability and Health Journal
IS - 2
ER -