Patients With High Mental Health Costs Incur Over 30 Percent More Costs Than Other High-Cost Patients

Abstract

A small proportion of health care users, called high-cost patients, account for a disproportionately large share of health care costs. Most literature on these patients has focused on the entire population. However, high-cost patients whose use of mental health care services is substantial are likely to differ from other members of the population. We defined a mental health high-cost patient as someone for whom mental health-related services accounted for at least 50 percent of total health care costs. We examined these patients' health care utilization and costs in Ontario, Canada. We found that their average cost for health care, in 2012 Canadian dollars, was $31,611. In contrast, the cost was $23,681 for other high-cost patients. Mental health high-cost patients were younger, lived in poorer neighborhoods, and had different health care utilization patterns, compared to other high-cost patients. These findings should be considered when implementing policies or interventions to address quality of care for mental health patients so as to ensure that mental health high-cost patients receive appropriate care in a cost-effective manner. Furthermore, efforts to manage mental health patients' health care use should address their complex profile through integrated multidisciplinary health care delivery.

Adverse mental health outcomes in a population‐based cohort of survivors of childhood cancer

“…We did not identify any such exposure: the risk of severe morbidity was not a consequence of cancer type, treatment intensity, or exposure to chemotherapy with a possible CNS impact. Lower socioeconomic status also has been associated with an elevated risk for mental health disorders, 44,45 but it is unclear whether this is a cause or a consequence of these outcomes in the general population. Nonbiologic causes of the risk for severe psychiatric events in survivors of cancer at young ages could be related to the impact of the cancer diagnosis on parental behavior and the considerable stress of a life-threatening illness on the child.…”

Applying a Bauhaus design approach to conceptualize an integrated system of mental health care: Lessons from a large urban hospital

“…Implementation of international quality-of-care metrics across mental health services would allow for a better understanding of outcome and recovery. A recent Canadian study found that "mental health high-cost patients", defined as those that acquire 50% or more of their total healthcare costs within the mental health domain, use 30% more healthcare expenses per capita compared with non-mental health high-cost patients (de Oliveira et al 2016). Furthermore, these health costs primarily resulted from psychiatric hospitalizations (de Oliveira et al 2016).…”

“…A recent Canadian study found that "mental health high-cost patients", defined as those that acquire 50% or more of their total healthcare costs within the mental health domain, use 30% more healthcare expenses per capita compared with non-mental health high-cost patients (de Oliveira et al 2016). Furthermore, these health costs primarily resulted from psychiatric hospitalizations (de Oliveira et al 2016). Between 2003 and2004, it was found that 37% of patients with a mental illness were readmitted to an acute care hospital within 1 year of being discharged in Canada as compared to 27.3% of patients with no mental illness (Canadian Institute for Health Information 2006; Madi et al 2007).…”

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

“…These databases have been validated and described in the literature 8 and have been used previously for costing analyses in Ontario. [9][10][11] A full description of each database can be found in Appendix 1 (available at www.cmajopen.ca/content/4/4/E661/suppl/ DC1). The databases were linked with the use of unique encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences.…”