Cost evaluation of out-of-country care for patients with eating disorders in Ontario: a population-based study

Oliveira, Claire de; Macdonald, Erin M.; Green, Diane; Colton, Patricia; Olmsted, Marion P.; Bondy, Susan; Kurdyak, Paul

doi:10.9778/cmajo.20160057

Cited by 4 publications

(3 citation statements)

References 24 publications

(18 reference statements)

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“…From published estimates (de Oliveira et al 2017b , 2016c ; Knapp et al 2004 ), we know that schizophrenia and eating disorders are among the most expensive mental health and addiction diagnostic categories. In the current study, eating disorders are not delineated due to privacy considerations of small numbers in Saskatchewan (< 5 individuals per year); schizophrenic disorders were the most expensive diagnostic category.…”

Section: Discussionmentioning

confidence: 99%

The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan

Anderson

Revie

Quail

et al. 2018

Can J Public Health

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ObjectiveA 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.MethodsWe 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.ResultsThe 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.ConclusionDespite 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.Electronic supplementary materialThe online version of this article (10.17269/s41997-018-0101-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan

Anderson

Revie

Quail

et al. 2018

Can J Public Health

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“…Previous studies have shown that the economic burden of eating disorders is substantial (de Oliveira et al, 2016;de Oliveira et al, 2017;Streatfeild et al, 2021). For example, when considering both economic costs and reduced wellbeing, one study found that the economic burden was as high as almost USD $400 billion for the fiscal year of 2018-2019 (Streatfeild et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Understanding the scope of preventable acute care spending among patients with eating disorders

Oliveira

Tanner

Colton

et al. 2023

Intl J Eating Disorders

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“…EDs are common, with Canadian studies reporting 2.2% of males and 4.5% of females under 18 years of age meeting criteria for an ED (Flament et al, 2015), and subclinical EDs among Canadian adolescents affecting approximately 25% of males and 30% of females (Henderson et al, 2017; McVey et al, 2004; McVey et al, 2005). Despite the high prevalence of these conditions, little literature exists as to the health care utilization patterns associated with these illnesses, and most studies have focused on the adult population (de Oliveira et al, 2016; de Oliveira et al, 2017; Mitchell et al, 2009; Striegel‐Moore et al, 2008; Toulany et al, 2015). Of note, many studies have commented on the under‐detection and under‐treatment of EDs, (Striegel‐Moore et al, 2008) which results in vastly underestimating the burden of illness (Simon et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

A retrospective cohort study examining health care utilization patterns in individuals diagnosed with an eating disorder in childhood and/or adolescence

Couturier

Gayowsky²,

Findlay

et al. 2022

Intl J Eating Disorders

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Objective: This study examined a 2-year period following an eating disorder (ED) diagnosis in order to determine patterns of health care utilization. Method:We conducted a retrospective cohort study of children (n = 1560) diagnosed with an ED between 2000 and 2017. The ED diagnosis was made at a tertiary level hospital for children and adolescents presenting for outpatient assessment by specialist adolescent medicine physicians and recorded in a program database over this period of time. We then created three sex-and age-matched comparison cohorts using provincial health administrative databases including: a general population cohort, a diabetes cohort (to compare nonmental health care utilization) and a mood disorder cohort (to compare mental health care utilization). Outcomes included hospitalizations, emergency department visits, as well as general practitioner, psychiatrist, and pediatrician visits. Odds ratios (dichotomous outcomes) and rate ratios (continuous outcomes) were calculated.Results: Compared to the general population cohort, the ED cohort had higher odds and rates of all types of health care utilization. Compared to the diabetes cohort, the ED cohort had higher odds of nonmental health-related admissions (OR 1.45, 95% CI 1.09-1.95) and higher rates of nonmental health-related emergency department visits (RR 1.59, 95% CI 1.18-2.13). Compared to the mood disorder cohort, the ED cohort had higher rates of pediatrician visits, which were mental health-related (RR 14.88, 95% CI 10.64-20.82), however most other types of mental health service utilization were lower.Discussion: These patterns indicate that the service needs of young people diagnosed with EDs are higher than those with diabetes with respect to nonmental health admissions and emergency department visits, while in terms of mental health service utilization, there appears to be a lack of use of mental health services compared to youth with mood disorders with the exception of pediatrician mental health visits. These findings must be interpreted in the context of under-detection and undertreatment of EDs.

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Cost evaluation of out-of-country care for patients with eating disorders in Ontario: a population-based study

Cited by 4 publications

References 24 publications

The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan

The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan

Understanding the scope of preventable acute care spending among patients with eating disorders

A retrospective cohort study examining health care utilization patterns in individuals diagnosed with an eating disorder in childhood and/or adolescence

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