Study identifies subgroups of top high-cost healthcare users

Patients in the top 1% of healthcare spending in North America account for 25% to 40% of total healthcare expenditures in a given year. As part of the study, the Alta. researchers categorized high-cost patients into distinctive groups within the high-cost population to develop a taxonomy of subgroups. The study identified nine subgroups:

1. People with cardiovascular disease (21.5%);
2. People receiving rehabilitation after surgery or recovering from complications of surgery (16%);
3. People with severe mental health conditions (14.5%);
4. People with advanced chronic kidney disease (12.7%);
5. People receiving biologic therapies for autoimmune conditions (12.0%);
6. People with dementia and awaiting community placement (11.9%);
7. People with COPD or other respiratory conditions (4.7%);
8. People receiving treatment for cancer (3.9%); and
9. People with unstable housing situations or substance use disorders (2.7%).

Researchers believe using such a taxonomy can inform policy and assist in identifying interventions most likely to improve care and reduce cost for each subgroup.