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[A focus on patients with the highest healthcare costs]
1Universiteit Maastricht, School for Public Health and Primary Care, Maastricht.
Insights
High healthcare costs often stem from managing multiple conditions, not just single expensive diseases. Focusing on efficiency for common, lower-cost conditions may be more effective for cost control.
Area of Science:
- Health Economics
- Healthcare Management
- Public Health Policy
Background:
- A significant portion of patients with the highest healthcare expenditures are treated for multiple comorbid conditions.
- Individual conditions may not be excessively costly, but their cumulative effect drives high overall costs.
Purpose of the Study:
- To analyze the relationship between multiple conditions and high healthcare costs.
- To inform cost-control policies by identifying key drivers of patient expenses.
Main Methods:
- Analysis of patient data to identify high-cost individuals.
- Examination of the number and types of conditions treated in high-cost patient cohorts.
Main Results:
- Patients in the top 1% of healthcare costs frequently have multiple co-occurring conditions.
- The accumulation of costs from managing several conditions, rather than single high-cost illnesses, is a primary driver of high patient expenditure.
Conclusions:
- Healthcare cost-control strategies should consider the impact of multiple conditions.
- Improving treatment efficiency for frequent, lower-to-medium cost conditions may offer greater cost-saving potential than focusing solely on rare, high-cost diseases.
Abstract:
Wammes et al. (2017) showed that many of the patients who are among the 1% with the highest healthcare costs are being treated for multiple conditions. This suggests that high healthcare costs are at least partly due to treatment for multiple conditions, each of which by itself may not be excessively costly. It is the accumulation of costs for multiple conditions that cause patients to become high-cost patients, and this has implications for cost-control policies. It may be more worthwhile to focus on improving efficiency in the treatment of conditions that occur frequently but have low or medium costs than on conditions with high costs but that occur infrequently.
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