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| Name | Class |
|---|---|
| Ontario Drug Policy Research Network (ODPRN) | UNKNOWN |
| Research Institute of St. Joseph's Hamilton | UNKNOWN |
High cost users (HCUs) are a small group of patients who use a disproportionate amount of health care resources. This study is a retrospective population-based matched cohort analysis of newly incident senior High Cost Users (HCUs) defined as Ontarians aged 66 years or older in the top 5% of healthcare expenditure users in fiscal year 2013 (FY2013). The study objectives are to characterize and contrast Ontario senior HCUs to non-HCUs based on their demographics, co-morbidities, medication use, health service utilization, healthcare expenditures, medication costs and clinical outcomes, and to determine the relative contribution of medications to senior HCUs expenditures
Senior high cost users (HCUs) with annual healthcare expenditures within the top 5% of Ontarians will be identified using established ICES costing algorithms. This cohort will be matched to a cohort of non-HCUs using a 3:1 matching ratio (non-HCU to HCU) based on age at cohort entry (+/- 1 month), sex and geographic location of residence (based on LHIN) for comparative analysis. Descriptive statistics will be used to describe the study populations and outcomes. Regression analyses will be used to adjust for potential confounders when analyzing healthcare resource utilization and costs as a function of HCU status (e.g. income, type of residence, co-morbidities, rural/urban) and/or when analyzing sub-populations [e.g. chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF)]. Logistic regression will be performed using the patient level data to predict the impact of individual factors on the likelihood of becoming a senior HCU.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HCUs | Newly incident seniors with annual total healthcare expenditures in the top 5% of Ontarians |
| |
| Non-HCUs | Seniors with annual total healthcare expenditures below the top 5% of Ontarians |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HCU Status | Other | Total healthcare expenditures in the top 5% of Ontarians |
|
| Measure | Description | Time Frame |
|---|---|---|
| Total healthcare expenditures per patient | 1 year after index date | |
| Total drug costs per patient | 1 year after index date | |
| Drug cost to total healthcare expenditure ratio | 1 year after index date |
| Measure | Description | Time Frame |
|---|---|---|
| All-cause mortality | 1 year after index date | |
| All-cause hospitalization rate | 1 year after index date |
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Inclusion Criteria:
Exclusion Criteria:
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Newly incident senior high cost users (HCUs) in Ontario
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| Name | Affiliation | Role |
|---|---|---|
| Justin Lee, BScPhm, ACPR, MD, FRCPC | McMaster University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33436455 | Derived | Lee J, Muratov S, Tarride JE, Paterson JM, Thavorn K, Mbuagbaw L, Gomes T, Khuu W, Seow H, Thabane L, Holbrook A. Medication use and its impact on high-cost health care users among older adults: protocol for the population-based matched cohort HiCOSTT study. CMAJ Open. 2021 Jan 11;9(1):E44-E52. doi: 10.9778/cmajo.20190196. Print 2021 Jan-Mar. |
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