title: [Concordance between stratification systems and identification of patients with multiple chronic diseases in Primary Care].
abstract: OBJECTIVE
  To determine the prevalence of patients with multiple chronic diseases in Primary Care using the multiple morbidity criteria and Clinical Risk Groups, and the agreement in identifying high-risk patients that require case management with both methods.
  
  
  METHODS
  A cross-sectional study was conducted on 240 patients, selected by random sampling of 16 care quotas from two Primary Health Care centres of a health area. Informed consent was obtained to access their electronic medical records for the study, and a record was made of age, sex, health status of Clinical Risk Groups, severity, multiple morbidity criteria, and Charlson index by physicians during clinical practice. Three patients were excluded due to incomplete data.
  
  
  RESULTS
  The prevalence of patients with multiple chronic diseases following the criteria of the Ministry of Health among users was 4.11 (95% CI; 2.13-7.30). The frequency of patients with high risk Clinical Risk Groups (G3) in the chronicity strategy of Valencian Community was 7.59 (95% CI; 4.70-11.70), which includes patients with health status 6 and complexity level 5-6, and health status 7, 8, and 9. Agreement between the two classifications was low, with a kappa index 0.17 (95% CI; 0-0.5) CONCLUSIONS: The prevalence did not differ significantly from that expected, and the agreement between the two stratifications was very weak, not selecting the same patients for highly complex case management.
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, España. Electronic address: manuelsanchezmolla@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez Mollá
authors.affiliation: CSI Santa Pola, Elche, Alicante, España.
authors.forename: I
authors.initials: I
authors.lastname: Candela García
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Gómez-Romero
authors.affiliation: Unidad de Docencia e Investigación, Departamento de Medicina Clínica, Universidad Miguel Hernández, Hospital Universitario de Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España.
authors.forename: D
authors.initials: D
authors.lastname: Orozco Beltrán
authors.affiliation: Unidad de Gestión Clínica de Atención Médica Integral, Hospital Universitario Virgen del Rocío, Sevilla, España; Sociedad Andaluza de Medicina Interna y Grupo de Atención de Pacientes Pluripatológicos y Edad Avanzada de la Sociedad Española de Medicina Interna, España.
authors.forename: M
authors.initials: M
authors.lastname: Ollero Baturone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071069:Multiple Chronic Conditions / Q000145:classification* / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012494:Sampling Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
keywords: Adjusted risk; Atención Primaria; Case management; Comorbidity; Comorbilidad; Estratificación del riesgo; Gestión de casos; Multiple morbidity; Pluripatología; Primary Care