Characteristics of high-cost health care users and non–high-cost users in the preincident year
| Characteristic | No. (%) of patients* | ASD† | |
|---|---|---|---|
| High-cost users n = 175 847 | Non–high-cost users n = 527 541 | ||
| Sociodemographic | |||
| Age, yr, mean ± SD | 77.66 ± 7.65 | 77.66 ± 7.65 | 0 |
| Female sex | 93 167 (53.0) | 279 501 (53.0) | 0 |
| Rural Index of Ontario score,‡ mean ± SD | 12.23 ± 18.20 | 11.81 ± 18.18 | 0.02 |
| Low income | 31 857 (18.1) | 92 566 (17.5) | 0.01 |
| Recent immigrant (< 15 yr in Canada) | 4211 (2.4) | 22 577 (4.3) | 0.11 |
| Health status | |||
| No. of Adjusted Diagnostic Groups, mean ± SD | 10.22 ± 4.00 | 7.93 ± 4.47 | 0.54 |
| Hypertension§ | 110 733 (63.0) | 282 867 (53.6) | 0.19 |
| Congestive heart failure¶ | 25 203 (14.3) | 36 877 (7.0) | 0.24 |
| Chronic obstructive pulmonary disease¶ | 48 761 (27.7) | 96 513 (18.3) | 0.23 |
| Diabetes¶ | 62 031 (35.3) | 138 794 (26.3) | 0.20 |
| Myocardial infarction¶ | 12 894 (7.3) | 24 024 (4.6) | 0.12 |
| Rheumatoid arthritis¶ | 5607 (3.2) | 9334 (1.8) | 0.09 |
| Malignant disease§ | 56 869 (32.3) | 123 932 (23.5) | 0.20 |
| Mental health condition§ | 67 468 (38.4) | 144 377 (27.4) | 0.24 |
| Health care use** | |||
| Long-term care facility | 835 (0.5) | 316 (0.1) | 0.08 |
| Primary care provider | |||
| Fee for service | 16 947 (9.6) | 45 751 (8.7) | 0.03 |
| Capitation | 48 717 (27.7) | 133 915 (25.4) | 0.05 |
| Enhanced fee for service†† | 51 665 (29.4) | 143 940 (27.3) | 0.05 |
| Family Health Team | 51 178 (29.1) | 137 516 (26.1) | 0.07 |
| Other‡‡ | 2149 (1.2) | 6249 (1.2) | 0 |
| None | 5191 (3.0) | 60 170 (11.4) | 0.33 |
| No. of medications, mean ± SD | 8.44 ± 4.96 | 5.61 ± 4.47 | 0.60 |
| Emergency department visits | 55 986 (31.8) | 101 896 (19.3) | 0.29 |
| No. of emergency department visits, mean ± SD | 0.56 ± 1.13 | 0.30 ± 0.80 | 0.26 |
| Visits to general practitioner | 168 090 (95.6) | 444 614 (84.3) | 0.38 |
| No. of visits to general practitioner, mean ± SD | 8.03 ± 6.79 | 5.63 ± 5.58 | 0.39 |
| Visits to specialist | 157 876 (89.8) | 391 557 (74.2) | 0.41 |
| No. of visits to specialist, mean ± SD | 7.40 ± 6.65 | 4.43 ± 5.13 | 0.50 |
| Visits to geriatrician | 4974 (2.8) | 5935 (1.1) | 0.12 |
| Home care visits | |||
| Nursing | 7223 (4.1) | 7385 (1.4) | 0.17 |
| No. of visits by nursing, mean ± SD | 0.54 ± 4.03 | 0.16 ± 2.00 | 0.12 |
| Personal support | 13 807 (7.8) | 10 612 (2.0) | 0.27 |
| No. of visits by personal support, mean ± SD | 6.44 ± 30.59 | 1.46 ± 13.53 | 0.21 |
| Allied health care | 9259 (5.3) | 7982 (1.5) | 0.21 |
| No. of visit by allied health care, mean ± SD | 0.18 ± 0.99 | 0.05 ± 0.52 | 0.17 |
| Other§§ | 27 638 (15.7) | 25 965 (4.9) | 0.36 |
| No. of visits by other, mean ± SD | 0.58 ± 2.30 | 0.14 ± 0.96 | 0.25 |
Note: ASD = absolute standardized difference, SD = standard deviation.
↵* Except where noted otherwise.
↵† A value greater than 0.1 indicates a meaningful difference between those admitted and not admitted to hospital.
↵‡ < 10 = urban, 10–39 = suburban, ≥ 40 = rural.
↵§ Constructed based on Johns Hopkins Expanded Diagnosis Codes.
↵¶ ICES-derived cohort.
↵** Mean values refer to mean number per person in fiscal year 2012/13.
↵†† Includes Comprehensive Care Model or Family Health Group.
↵‡‡ Includes primary care models other than Comprehensive Care Model or Family Health Group, and patients who were not enrolled with any primary care group but had at least 1 Ontario Health Insurance Plan claim.
↵§§ Includes a combination of social support, respite care and case management.