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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1990-3-15
|
| pubmed:abstractText |
This article describes the high-cost and very high-cost patients in the fee-for-service medical plan of one of the nation's largest banks in terms of their demographics and medical plan expenses and utilization, within a single year and during a period of 4 consecutive years. High-cost patients ($5,000-25,000 annually) were dominated by older persons and women 20 to 39 years, while the very high-cost patients (at least $25,000) tended to be older men and infants of both genders. Very high-cost patients used 5 to 7 times more hospital patient days and visited with a physician on an outpatient basis twice as often as high-cost patients. In turn, the high-cost patients experienced 37 to 50 times as many patient days and twice as many outpatient visits as patients whose annual expenses were below $5,000. Longitudinal analyses suggested that while most of the high-cost patients are typically low-cost patients or nonusers of services who experience high-cost time spans, some of them suffer from more serious chronic health problems and are apt to become very high-cost patients. Focusing case-management interventions on this small subgroup of high-cost patients may prevent some very high-cost cases in the future.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Feb
|
| pubmed:issn |
0025-7079
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
28
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
112-23
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:2105413-Adolescent,
pubmed-meshheading:2105413-Adult,
pubmed-meshheading:2105413-Age Factors,
pubmed-meshheading:2105413-California,
pubmed-meshheading:2105413-Catastrophic Illness,
pubmed-meshheading:2105413-Child,
pubmed-meshheading:2105413-Child, Preschool,
pubmed-meshheading:2105413-Fees, Medical,
pubmed-meshheading:2105413-Female,
pubmed-meshheading:2105413-Health Benefit Plans, Employee,
pubmed-meshheading:2105413-Health Expenditures,
pubmed-meshheading:2105413-Hospitalization,
pubmed-meshheading:2105413-Humans,
pubmed-meshheading:2105413-Infant,
pubmed-meshheading:2105413-Infant, Newborn,
pubmed-meshheading:2105413-Insurance, Health,
pubmed-meshheading:2105413-Longitudinal Studies,
pubmed-meshheading:2105413-Male,
pubmed-meshheading:2105413-Middle Aged,
pubmed-meshheading:2105413-Office Visits,
pubmed-meshheading:2105413-Sex Factors
|
| pubmed:year |
1990
|
| pubmed:articleTitle |
High-cost patients in a fee-for-service medical plan. The case for earlier intervention.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|