de Oliveira Claire, Cheng Joyce, Vigod Simone, Rehm Jürgen, Kurdyak Paul
Claire de Oliveira (
Joyce Cheng is a project coordinator at CAMH.
Health Aff (Millwood). 2016 Jan;35(1):36-43. doi: 10.1377/hlthaff.2015.0278.
A small proportion of health care users, called high-cost patients, account for a disproportionately large share of health care costs. Most literature on these patients has focused on the entire population. However, high-cost patients whose use of mental health care services is substantial are likely to differ from other members of the population. We defined a mental health high-cost patient as someone for whom mental health-related services accounted for at least 50 percent of total health care costs. We examined these patients' health care utilization and costs in Ontario, Canada. We found that their average cost for health care, in 2012 Canadian dollars, was $31,611. In contrast, the cost was $23,681 for other high-cost patients. Mental health high-cost patients were younger, lived in poorer neighborhoods, and had different health care utilization patterns, compared to other high-cost patients. These findings should be considered when implementing policies or interventions to address quality of care for mental health patients so as to ensure that mental health high-cost patients receive appropriate care in a cost-effective manner. Furthermore, efforts to manage mental health patients' health care use should address their complex profile through integrated multidisciplinary health care delivery.
一小部分医疗保健使用者,即所谓的高成本患者,在医疗保健费用中所占份额 disproportionately 大。关于这些患者的大多数文献都集中在整个人口上。然而,大量使用心理健康护理服务的高成本患者可能与其他人群有所不同。我们将心理健康高成本患者定义为心理健康相关服务占总医疗保健费用至少 50% 的人。我们研究了加拿大安大略省这些患者的医疗保健利用情况和费用。我们发现,以 2012 年加拿大元计算,他们的平均医疗保健费用为 31,611 美元。相比之下,其他高成本患者的费用为 23,681 美元。与其他高成本患者相比,心理健康高成本患者更年轻,居住在较贫困的社区,并且有不同的医疗保健利用模式。在实施旨在解决心理健康患者护理质量的政策或干预措施时,应考虑这些发现,以确保心理健康高成本患者以具有成本效益的方式获得适当的护理。此外,管理心理健康患者医疗保健使用的努力应通过综合多学科医疗保健服务来解决他们复杂的情况。