Characteristics of persistently high-cost subgroups
| Characteristic | Subgroup, %* | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Overall, n (%) n = 21 115 | CVD n = 4537 | Rehab. or care after surgery n = 3380 | Severe mental health conditions n = 3060 | Advanced CKD n = 2689 | Biologic therapies for autoimmune conditions n = 2538 | Dementia and awaiting comm. placement n = 2520 | COPD or other respiratory conditions n = 984 | Treatment for cancers n = 832 | Unstable housing or substance use n = 575 | |
| Age, yr | ||||||||||
| Mean ± SD | 60.2 ± 18.4 | 73.5 ± 11.6 | 56.5 ± 15.5 | 47.4 ± 15.7 | 59.0 ± 14.5 | 41.8 ± 13.4 | 81.1 ± 7.6 | 61.2 ± 9.7 | 59.1 ± 12.1 | 41.2 ± 11.5 |
| 18–49 | 5810 (27.5) | 2.6 | 28.1 | 50.5 | 26.0 | 72.7 | 0.2 | 6.5 | 16.5 | 77.6 |
| 50–64 | 6182 (29.3) | 20.5 | 39.4 | 37.1 | 38.2 | 22.1 | 1.1 | 63.2 | 51.1 | 21.2 |
| 65–74 | 4008 (19.0) | 26.7 | 25.4 | 11.3 | 23.1 | 4.6 | 16.0 | 23.8 | 25.8 | 1.0 |
| 75+ | 5115 (24.2) | 50.2 | 7.2 | 1.1 | 12.8 | 0.5 | 82.7 | 6.5 | 6.6 | 0.2 |
| Male | 11 371 (53.9) | 58.4 | 62.1 | 53.8 | 61.7 | 47.3 | 34.6 | 59.5 | 43.4 | 52.3 |
| Urban residence | 18130 (86.2†) | 81.1 | 71.1 | 94.1 | 90.5 | 91.0 | 93.4 | 92.7 | 90.8 | 81.3 |
| History of homelessness | 486 (2.3) | 0.2 | 0.4 | 7.9 | 0.0 | 0.0 | 0.0 | 0.2 | 0.0 | 38.3 |
| Continuing care | 5957 (28.2) | 37.2 | 20.3 | 50.5 | 5.5 | 0.1 | 65.2 | 10.4 | 6.5 | 15.5 |
| ≥ 1 hospitalizations in the previous 12 mo | 7570 (35.9) | 57.8 | 6.8 | 44.2 | 26.6 | 21.7 | 29.6 | 84.3 | 4.0 | 85.7 |
| Emergency department visits in the previous 12 months | ||||||||||
| 0 | 8933 (42.3) | 21.9 | 69.6 | 31.8 | 51.7 | 50.6 | 46.2 | 14.2 | 76.7 | 0.0 |
| 1–4 | 9122 (43.2) | 57.6 | 21.1 | 47.8 | 40.9 | 40.1 | 50.1 | 70.7 | 23.2 | 10.3 |
| 5–15 | 2575 (12.2) | 18.5 | 7.8 | 16.6 | 6.8 | 8.0 | 3.4 | 14.8 | 0.0 | 60.5 |
| 16+ | 485 (2.3) | 2.0 | 1.6 | 3.8 | 0.5 | 1.3 | 0.3 | 0.2 | 0.1 | 29.2 |
| Primary care provider attachment in the previous 2 years | ||||||||||
| < 50% | 14 037 (66.5) | 71.2 | 69.3 | 77.8 | 45.3 | 47.2 | 84.4 | 58.0 | 49.3 | 96.3 |
| 50%–74.9% | 4908 (23.2) | 21.8 | 22.5 | 16.7 | 31.4 | 31.9 | 14.4 | 31.3 | 35.8 | 3.7 |
| > 75% | 2084 (9.9) | 6.7 | 7.8 | 5.4 | 22.5 | 19.3 | 1.1 | 10.7 | 14.9 | 0.0 |
| Few visits | 86 (0.4) | 0.3 | 0.4 | 0.1* | 0.8 | 1.5 | 0.0 | 0.0 | 0.0 | 0.0 |
| Number of specialist types visited at least twice in the previous year | ||||||||||
| 0 | 4089 (19.4) | 9.5 | 72.5 | 10.4 | 4.1 | 8.0 | 22.1 | 0.0 | 1.0 | 2.1 |
| 1 | 4470 (21.2) | 13.9 | 19.6 | 24.0 | 20.2 | 36.2 | 20.6 | 0.0 | 49.8 | 8.2 |
| 2–3 | 7673 (36.3) | 36.6 | 7.8 | 42.5 | 48.6 | 42.8 | 37.7 | 43.8 | 44.5 | 53.0 |
| 4+ | 4883 (23.1) | 40.1 | 0.0 | 23.1 | 27.1 | 13.0 | 19.6 | 56.2 | 4.8 | 36.7 |
| Underlying medical diagnoses | ||||||||||
| Alcohol misuse | 3364 (15.9) | 10.3 | 13.8 | 46.7 | 7.0 | 3.2 | 1.7 | 20.7 | 1.3 | 82.1 |
| Depression | 5001 (23.7) | 16.9 | 6.2 | 70.4 | 10.0 | 18.5 | 16.3 | 20.9 | 14.1 | 68.9 |
| Schizophrenia | 1987 (9.4) | 1.4 | 0.8 | 55.1 | 0.7 | 1.2 | 1.5 | 1.8 | 0.0 | 17.9 |
| COPD | 6702 (31.7) | 59.3 | 23.3 | 32.2 | 18.7 | 11.6 | 28.8 | 41.1 | 13.7 | 33.9 |
| Dementia | 1510 (7.2) | 12.3 | 0.5 | 13.2 | 0.0 | 0.2 | 19.5 | 2.0 | 0.0 | 2.6 |
| Diabetes | 7439 (35.2) | 65.8 | 24.8 | 29.4 | 60.0 | 7.7 | 26.0 | 8.7 | 4.8 | 22.4 |
| CAD | 7289 (34.5) | 88.8 | 12.5 | 20.2 | 31.0 | 6.7 | 34.3 | 24.1 | 6.0 | 11.3 |
| Heart failure | 4398 (20.8) | 70.3 | 2.9 | 8.3 | 18.1 | 1.3 | 8.9 | 8.5 | 0.0 | 4.7 |
| Hypertension | 13 264 (62.8) | 99.3 | 45.5 | 43.8 | 95.8 | 16.4 | 85.2 | 43.6 | 19.0 | 28.0 |
| CKD | 6771 (32.1) | 64.7 | 8.8 | 18.9 | 70.9 | 12.3 | 14.4 | 17.0 | 9.1 | 24.3 |
| Autoimmune condition | 1552 (7.4) | 1.2 | 0.5 | 0.3 | 0.3 | 56.0 | 1.3 | 0.2 | 0.0 | 0.7 |
| Stroke | 4055 (19.2) | 41.2 | 8.5 | 14.2 | 13.1 | 4.6 | 28.7 | 15.7 | 3.4 | 15.7 |
| Cancer | 3318 (15.7) | 20.5 | 8.6 | 7.3 | 14.6 | 4.1 | 19.2 | 52.1 | 38.6 | 10.1 |
| Mean per person cost, $ | 136 735 | 121 454 | 133 880 | 178 946 | 143 291 | 112 200 | 119 263 | 150 302 | 178 920 | 119 407 |
| Outpatient | 13 542 | 13 953 | 14 028 | 18 227 | 14 149 | 6808 | 11 905 | 14 119 | 11 937 | 17 909 |
| Emergency department | 19 912 | 27 582 | 15 018 | 12 448 | 46 423 | 8447 | 9297 | 16 225 | 14 041 | 15 815 |
| Hospital | 64 076 | 70 520 | 77 355 | 75 948 | 49 156 | 22 181 | 81 439 | 61 269 | 54 776 | 68 866 |
| Medication | 39 205 | 9398 | 27 479 | 72 323 | 33 563 | 74765 | 16 623 | 58 689 | 98 167 | 16 817 |
| Median per person cost, $ | 76 915 | 86 544 | 83 924 | 86 207 | 82 093 | 61 927 | 88 990 | 77 745 | 68 940 | 85 440 |
| Outpatient | 12 033 | 12 550 | 12 255 | 16 085 | 12 488 | 3052 | 10 803 | 12 413 | 10 245 | 16 320 |
| Emergency department | 7418 | 9386 | 7260 | 6055 | 29 292 | 3396 | 4688 | 8840 | 6725 | 12 222 |
| Hospital | 52 593 | 60 229 | 61 299 | 58 846 | 34 643 | 2789 | 70 641 | 49 738 | 42 351 | 52 624 |
| Medication | 4871 | 4379 | 3111 | 5221 | 5670 | 52 689 | 2858 | 6754 | 9620 | 4274 |
Note: CKD = chronic kidney disease, comm. = community, COPD = chronic obstructive pulmonary disease, CVD = cardiovascular disease, ED = emergency department, rehab. = rehabilitation, SD = standard deviation.
Light grey shading indicates that the ratio of the characteristic relative to the overall persistent high-cost population was less than 0.5. Dark grey shading indicates that the ratio of the characteristic relative to the overall persistent high-cost population was 2.0 or greater, or had a prevalence of 90% or higher.
↵* Except where indicated otherwise.
↵† Data were available for n = 21 032 individuals.