What Happens to High-Cost Patients? An Analysis of the Trajectories of Billed Charges Over Time.
Popul Health Manag
; 20(5): 362-367, 2017 10.
Article
en En
| MEDLINE
| ID: mdl-28574810
ABSTRACT
A growing literature documents the substantial burden that a small proportion of high-cost, medically complex patients impose on health care systems. However, it is not clear whether high-cost patients remain costly over time. This study looks at the monthly distribution of billed charges for a cohort of high-cost, medically complex patients enrolled in an intensive care management program in a university health care system, and finds that the billing trajectory is heterogeneous and highly nonlinear, characterized by a substantial spike in billed charges prior to identification, followed by a considerable drop prior to enrollment and a sustained drop thereafter. The conclusion is that many high-cost patients experience costly events that resolve without intensive case management. These results also suggest that interventions should target only those high-cost patients with expected continued high cost and that pre-post study designs may overstate the impact of interventions for high-cost, medically complex patients.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Manejo de Atención al Paciente
/
Costos de la Atención en Salud
/
Análisis Costo-Beneficio
Tipo de estudio:
Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Popul Health Manag
Asunto de la revista:
SAUDE PUBLICA
/
SERVICOS DE SAUDE
Año:
2017
Tipo del documento:
Article