Table 3

Expenditure patterns and utilisation of high-cost patients

Spending categoryNumber of studies
(Inpatient) hospital care3115–19 22–25 27–30 32–39 60 66–68 73 75 78 79 82 85
Subacute care/postacute care services rehabilitation119 15 22 27 30 35 38 39 66 67 75
Hospitalisations/admission/ patient days/length of stay1717–19 23 26 35 36 39 60 68 73 74 77–79 81 85
Emergency department1219 26 29 35–38 60 73 77 78 85
Outpatient (physician) visits1319 27 34–37 39 65 73 77 82 83 85
Long-term care1115 16 22 30 39 66 67 70 73 78 83
Mental health1017 18 22 36 38 61 67 73 83 85
Physician services1315 18 27 35–37 68 73 74 81–83 85
Intensive care unit2 78 17
Prescription drugs1617 19 23 30 35–37 62 65 67 68 75 77–79 85
Persistency
 Subsequent use1316 20 21 23 29 31–33 62 67 72 82 83
 Prior use521 32 58 60 65
 Persistent users2115 16 20–23 26 29 31–33 37 57 58 60 62 65 67 72 82 83
Prediction of high-cost patients*1622 25 58–60 63–65 68–70 77 79 80 83 84
  • *An in-depth discussion of prediction models for high costs is beyond the scope of the article (though individual predictors are used throughout the paper). Generally, diagnosis-based models outperform prior cost models, and combinations accurately predict high-cost patients. Besides, comorbidity indices also accurately predict high-cost patients, and self-reported health data meaningfully improved existing models.