title: Who would most benefit from improved integrated care? Implementing an analytical strategy in South Somerset.
abstract: OBJECTIVE
  The Symphony Project is designed to identify which groups of the South Somerset population in England would most benefit from greater integration across primary, community, acute and social care settings.
  
  
  METHODS
  We analysed linked health and social care data for the entire South Somerset population for the financial year 2012/2013. The data captured acute, primary, community, mental health and social care utilisation and costs; demographic characteristics; and indicators of morbidity for each individual. We employed generalized linear models to analyse variation in annual health and social care costs for all 114,874 members of the South Somerset population and for 1458 individuals with three or more selected chronic conditions.
  
  
  RESULTS
  We found that multi-morbidity, not age, was the key driver of health and social care costs. Moreover, the number of chronic conditions is as useful as information about specific conditions at predicting costs. We are able to explain 7% of the variation in total annual costs for population as a whole, and 14% of the variation for those with three or more conditions. We are best able to explain primary care costs, but explanatory power is poor for mental health and social care costs.
  
  
  CONCLUSIONS
  The linked dataset makes it possible to understand existing patterns of health and social care utilisation and to analyse variation in annual costs, for the whole population and for sub-groups, in total and by setting. This has made it possible to identify who would most benefit from improved integrated care and to calculate capitated budgets to support financial integration.
authors: Centre for Health Economics, University of York, UK.
authors: Panagiotis
authors: P
authors: Kasteridis
authors: Health Economics, Centre for Health Economics, University of York, UK.
authors: Andrew
authors: A
authors: Street
authors: Clinical Operations Group, Somerset Clinical Commissioning Group, Yeovil, Somerset, UK.
authors: Matthew
authors: M
authors: Dolman
authors: South West Commissioning Support, Bridgwater, UK.
authors: Lesley
authors: L
authors: Gallier
authors: Business Solutions and Innovation, South West Commissioning Support, Bridgwater, UK.
authors: Kevin
authors: K
authors: Hudson
authors: The Symphony Project, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, Somerset, UK.
authors: Jeremy
authors: J
authors: Martin
authors: South Somerset Healthcare Federation, Milborne Port Surgery, Gainsborough, Milborne Port, UK.
authors: Ian
authors: I
authors: Wyer
keywords: capitated budgets; health and social care costs; integrated care; morbidity profiles