Table 2

Ten conditions with highest total costs among top 1% beneficiaries

Prevalence (%)*% of total costs†% as most cost-incurring condition‡% most cost-incurring/prevalence§% of costs by most cost-incurring condition¶
N17-N19 Renal failure12.26.86.452.466.0
C81-C96 Leukaemia5.
C15-C26 Malignant neoplasms of digestive organs7.52.45.471.247.9
I60-I69 Cerebrovascular diseases7.
I70-I79 Diseases of arteries, arterioles and capillaries9.
C30-C39 Lung cancer5.91.73.559.152.5
I51-I52 Complications/ill-defined descriptions, other heart disorders9.
I44–I49 Atrial fibrillation, rhythm and conduction disorders11.81.62.924.358.5
I20-I25 Ischaemic heart diseases12.71.63.729.041.9
I50 Heart failure9.31.52.628.457.1
  • *Prevalence of each ICD-10 subchapter among top 1% beneficiaries. For example, 12.2% of top 1% beneficiaries were treated for renal failure.

  • †Sum of total treatment costs per ICD-10 subchapter. For example, treatment of renal failure accounted for 6.8% of total expenditures of top 1% beneficiaries.

  • ‡Percentage of top 1% with this ICD-10 subchapter as most cost-incurring condition. For example, 6.4% of top 1% beneficiaries had renal failure as most cost-incurring condition.

  • §Percentage most cost-incurring condition relative to prevalence: fourth column divided by second column. For example, for 52.4% of top 1% beneficiaries who were treated for renal failure, this was also their most cost-incurring condition.

  • ¶Percentage of costs accounted for by the most cost-incurring condition. For example, among top 1% beneficiaries with renal failure as most cost-incurring condition, this disease accounted for on average 66% of total costs per beneficiary.