Predicting patients with high risk of becoming high-cost healthcare users in Ontario (Canada)

Healthcare Policy

Volumn 9, Issue 3, 2014, Pages 68-79

  Chechulin, Yuriy ^a   Nazerian, Amir ^a   Rais, Saad ^a   Malikov, Kamil ^a  

^a ONTARIO MINISTRY OF HEALTH AND LONG TERM CARE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CANADA; COHORT ANALYSIS; DEMOGRAPHY; FOLLOW UP; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE UTILIZATION; HEALTH SERVICE; HIGH COST USER; HIGH RISK PATIENT; HUMAN; INTERVENTION STUDY; PATIENT IDENTIFICATION; SENSITIVITY AND SPECIFICITY; COST OF ILLNESS; ECONOMICS; FEMALE; FORECASTING; MALE; PROCEDURES; RISK; STATISTICAL MODEL; TRENDS; UTILIZATION;

COST OF ILLNESS; FEMALE; FORECASTING; HEALTH CARE COSTS; HEALTH SERVICES; HUMANS; MALE; MODELS, STATISTICAL; ODDS RATIO; ONTARIO;

EID: 84902210762     PISSN: 17156572     EISSN: 17156580     Source Type: Journal    
DOI: 10.12927/hcpol.2014.23710     Document Type: Article

References (21)

1. Ash, A.S., Y. Zhao, R.P. Ellis and M.S. Kramer. 2001. "Finding Future High-Cost Cases: Comparing Prior Cost versus Diagnosis-Based Methods." Health Services Research 36(6 Part II): 194-206.
2. Berk, M.L. and A.C. Monheit. 2001. "The Concentration of Health Care Expenditures, Revisited." Health Affairs 20(2): 9-18.
3. Billings, J., J. Dixon, T. Mijanovich and D. Wennberg. 2006. "Case Finding for Patients at Risk of Readmission to Hospital: Development of Algorithm to Identify High-Risk Patients." British Medical Journal 333(7563): 327. doi: 10.1136/bmj.38870.657917.AE.
4. Billings, J., T. Georghiou, I. Blunt and M. Bardsley. 2013. "Choosing a Model to Predict Hospital Admission: An Observational Study of New Variants of Predictive Models for Case Finding." BMJ Open 3: e003352. doi:10.1136/bmjopen-2013-003352.
5. Calver, J., K.J. Brameld, D.B. Preen, S.J. Alexia, D.P. Boldy and K.A. McCaul. 2006. "High-Cost Users of Hospital Beds in Western Australia: A Population-Based Record Linkage Study." Medical Journal of Australia 184: 393-97.
6. Center for Healthcare Research and Transformation. 2010. "Health Care Cost Drivers: Chronic Disease, Comorbidity, and Health Risk Factors in the U.S. and Michigan." Retrieved January 29, 2014. 〈http://www.chrt.org/ assets/price-of-care/CHRT-Issue-Brief-August-2010.pdf〉.
7. Fleishman, H.A. and J.W. Cohen. 2010. "Using Information on Clinical Conditions to Predict High-Cost Patients." Health Services Research 45(2): 532-52.
8. Gawande, A. 2011 (January). "The Hot Spotters: Can We Lower Medical Costs by Giving the Neediest Patients Better Care?" The New Yorker. January 2011. Retrieved January 29, 2014. 〈http://www.newyorker.com/reporting/ 2011/01/24/110124fa-fact-gawande〉.
9. Government of Scotland. 2010. "SPARRA Made Easy." Retrieved January 29, 2014. 〈http://www.scotland.gov.uk/Publications/2010/04/ 13104303/1〉.
10. Government of Scotland. 2012. "Scottish Patients at Risk of Readmission and Admission (SPARRA): A Report on the Development of SPARRA Version 3 (Developing Risk Prediction to Support Preventative and Anticipatory Care in Scotland)." Retrieved January 29, 2014. 〈http://www. isdscotland.org/Health-Topics/Health-and-Social-Community-Care/SPARRA/ 2012-02-09-SPARRA-Version-3.pdf〉.
11. Hosmer, D.W. and S. Lemeshow. 2000. Applied Logistic Regression (2nd ed.). New York: John Wiley & Sons.
12. Kozyrskyj, A., L. Lix, M. Dahl and R. Soodeen. 2005 (March). High-Cost Users of Pharmaceuticals: Who Are They? Winnipeg: Manitoba Centre for Health Policy. Retrieved January 29, 2014. 〈http://mchp-appserv.cpe.umanitoba.ca/ reference/high-cost.pdf〉.
13. Ministry of Health and Long-Term Care (MOHLTC). n.d. "Ontario's Action Plan for Health Care." Retrieved January 29, 2014. 〈http://www.health.gov.on.ca/en/ms/ecfa/healthy-change/docs/ rep-healthychange.pdf〉.
14. Moturu, S.T., W.G. Johnson and H. Liu. 2010. "Predictive Risk Modelling for Forecasting High-Cost Patients: A Real-World Application Using Medicaid Data." International Journal of Biomedical Engineering and Technology 3(1/2): 114-32.
15. Pampalon, R., D. Hamel, P. Gamache and G. Raymond. 2009. "A Deprivation Index for Health Planning in Canada." Chronic Diseases in Canada 29(4): 178-91.
16. Rais, S., A. Nazerian, S. Ardal, Y. Chechulin, N. Bains and K. Malikov. 2013. "High Cost Users of Ontario's Healthcare Services." Healthcare Policy 9(1): 44-51.
17. Reid, R., R. Evans, M. Barer, S. Sheps, K. Kerluke, K. McGrail, C. Hertzman and N. Pagliccia. 2003. "Conspicuous Consumption: Characterizing High Users of Physician Services in One Canadian Province." Journal of Health Services Research & Policy 8(4): 215-24.
18. Silversides, A. and A. Laupacis. 2013 (February 28). "Health Links: Ontario's Bid to Provide More Efficient and Effective Care for Its Sickest Citizens." Retrieved January 29, 2014. 〈http://healthydebate.ca/2013/ 02/topic/innovation/the-ontario-health-links-initiative-what-is-it〉.
19. The Commonwealth Fund. 2012 (April). "The Performance Improvement Imperative: Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients." Retrieved January 29, 2014. 〈http://www.commonwealthfund.org/Publications/Fund-Reports/2012/Apr/ Performance-Improvement-Imperative.aspx〉.
20. Walraven, C., D.A. Irfan, C. Bell, E. Etchells, I.G. Stiell, K. Zarnke et al. 2010. "Derivation and Validation of an Index to Predict Early Death or Unplanned Readmission After Discharge from Hospital to the Community." Canadian Medical Association Journal 182(6). doi: 10.1503/cmaj.091117.
21. Wijeysundera, H.C., G. Trubiani, L. Abrahamyan, N. Mitsakakis, W. Witteman, M. Paulden et al. 2012. "Specialized Multi-Disciplinary Heart Failure Clinics in Ontario, Canada: An Environmental Scan." BMC Health Services Research 12: 236. doi: 10.1186/1472-6963-12-236.