The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan.
Maureen Anderson,Maureen Anderson,Crawford W. Revie,Jacqueline Quail,Jacqueline Quail,Walter P. Wodchis,Claire de Oliveira,Claire de Oliveira,Meric Osman,Marilyn Baetz,Marilyn Baetz,J.T. McClure,Henrik Stryhn,David L. Buckeridge,Cordell Neudorf,Cordell Neudorf +15 more
TLDR
Efforts to reduce high-cost use should focus on reduction of multimorbidity, connection to a primary care provider (particularly for those with more than one MHA), young patients with schizophrenia, and adequately addressing housing stability.Abstract:
A small proportion of the population accounts for the majority of healthcare costs. Mental health and addiction (MHA) patients are consistently high-cost. We aimed to delineate factors amenable to public health action that may reduce high-cost use among a cohort of MHA clients in Saskatoon, Saskatchewan. We conducted a population-based retrospective cohort study. Administrative health data from fiscal years (FY) 2009–2015, linked at the individual level, were analyzed (n = 129,932). The outcome of interest was ≥ 90th percentile of costs for each year under study (‘persistent high-cost use’). Descriptive analyses were followed by logistic regression modelling; the latter excluded long-term care residents. The average healthcare cost among study cohort members in FY 2009 was ~ $2300; for high-cost users it was ~ $19,000. Individuals with unstable housing and hospitalization(s) had increased risk of persistent high-cost use; both of these effects were more pronounced as comorbidities increased. Patients with schizophrenia, particularly those under 50 years old, had increased probability of persistent high-cost use. The probability of persistent high-cost use decreased with good connection to a primary care provider; this effect was more pronounced as the number of mental health conditions increased. Despite constituting only 5% of the study cohort, persistent high-cost MHA clients (n = 6455) accounted for ~ 35% of total costs. Efforts to reduce high-cost use should focus on reduction of multimorbidity, connection to a primary care provider (particularly for those with more than one MHA), young patients with schizophrenia, and adequately addressing housing stability.read more
Citations
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Administration and policy in mental health
TL;DR: The upshot of these needs for change is both dismaying and exciting, both disturbing in the destruction of long-familiar patterns of dealing with human suffering, and paradoxically hopeful in raising the possibility that significant failures in health care systems of the past may now be addressed more successfully.
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Association between perceived stress, multimorbidity and primary care health services: a Danish population-based cohort study.
TL;DR: Perceived stress levels were associated with primary care activity in a dose–response relation when adjusted for underlying conditions, lifestyle and socioeconomic factors, and for those with multimorbidity, stress was associated with more out-of-hours services, but not with more chronic care services.
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Population-Based Evidence From a Western Canadian Province of the Decreasing Incidence Rates and Trends of Inflammatory Bowel Disease Among Adults.
J A Osei,Juan Nicolás Peña-Sánchez,Sharyle Fowler,Nazeem Muhajarine,Gilaad G. Kaplan,Lisa M. Lix +5 more
TL;DR: The incidence of inflammatory bowel disease in Saskatchewan dropped significantly from 1999 to 2016 with urban dwellers having a 19% higher risk of IBD onset compared to their rural counterparts.
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Modeling socio-demographic and clinical factors influencing psychiatric inpatient service use: a comparison of models for zero-Inflated and overdispersed count data.
TL;DR: Providing easier access to registered Indian people and youth may reduce the need for hospital-based care, which may help the policy makers to target the high-risk groups in a more focused manner.
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Defining ‘actionable’ high- costhealth care use: results using the Canadian Institute for Health Information population grouping methodology
Maureen Anderson,Maureen Anderson,Crawford W. Revie,Crawford W. Revie,Henrik Stryhn,Cordell Neudorf,Cordell Neudorf,Yvonne Rosehart,Wenbin Li,Meric Osman,David L. Buckeridge,Laura C. Rosella,Walter P. Wodchis +12 more
TL;DR: Population segmentation methods, and more specifically, the CIHI Population Grouping Methodology, provide specificity to high-cost health care use; informing interventions aimed at reducing health care costs and improving population health.
References
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Administration and policy in mental health
TL;DR: The upshot of these needs for change is both dismaying and exciting, both disturbing in the destruction of long-familiar patterns of dealing with human suffering, and paradoxically hopeful in raising the possibility that significant failures in health care systems of the past may now be addressed more successfully.
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