Study Questions Thinking About Health Care ‘Super-Utilizers’
Although experts have long believed that patients with serious illnesses who visit the hospital and emergency department frequently do so over the long term, a study published recently in Health Affairs points out that such patients actually use health care services intensely for a relatively short time, Kaiser Health News reports.
Such patients -- called "super-utilizers" or "frequent flyers" -- account for a large share of health care spending and tend to be uninsured or have coverage through Medicare or Medicaid (Andrews, Kaiser Health News, 8/7).
For the study, researchers examined data from 2011 to 2013 on patients who were either uninsured or were Medicare or Medicaid beneficiaries (Budryk, FierceHealthcare, 8/5). They looked at costs and characteristics of patients who were hospitalized more than three times between May 1, 2011, and April 30, 2013, or had been hospitalized at least twice in one year and had serious mental health issues.
The researchers found that 28% of patients initially identified as super-utilizers still were considered super-utilizers after one year. That percentage dropped to 14% after two years. Meanwhile, per-person spending decreased as a result of their decreased use of services, from a baseline of $113,522 per capita to $47,017 per capita in the second year (Kaiser Health News, 8/7).
The researchers also discovered that such patients did not necessarily have the characteristics commonly associated with frequent flyers. For example, 18% did not have mental health issues, nor were they homeless (FierceHealthcare, 8/5).
Further, researchers found that 42% of the high-cost patients with frequent hospital stays they studied had multiple chronic conditions. Tracy Johnson, study lead author and director of health care reform initiatives at Denver Health, said, "You'd think they'd all be people with multiple chronic conditions."
Johnson said, "Other literature we saw said that there's this homogenous group of people," adding, "but what we saw is that it's more nuanced." According to KHN, many programs designed to address super-utilizers focus on treating multiple conditions, but the study indicates that frequent flyers might benefit from different types of programs (Kaiser Health News, 8/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.