Publications (2)3.46 Total impact
-
Article: Unhealthy markets: financial crisis, fiscal crisis ... health care crisis?
Journal of Health Services Research & Policy 05/2009; 14(2):68-9. · 1.73 Impact Factor -
Article: Conspicuous consumption: characterizing high users of physician services in one Canadian province.
[show abstract] [hide abstract]
ABSTRACT: To examine medical care use and costs, patterns of morbidity and co-morbidity, and other patient characteristics of high users of physician services in British Columbia. This population-based study uses physician claims, hospital discharge summaries and vital statistics data linked at the level of the individual to compare characteristics of high users, other users and non-users of physician services in the Province of British Columbia, Canada. The study included all enrolled adults in the universal health care plan during fiscal year 1996/97. High users were defined as the most costly 5% of users of fee-reimbursed services. Key variables included age, sex, an ecological socio-economic status indicator and a comprehensive set of morbidity indicators, derived from the diagnoses recorded on the utilization records. The top 5% of users consumed a disproportionate 30% of spending on physician services. High users were overwhelmingly characterized by a significant burden of morbidity. Over 80% had at least six different types of morbidity during the study year compared with fewer than 20% of other users. High users were also much more likely to have major diagnoses that were both acute and chronic in nature. Co-morbidity involving psychosocial and chronic medical conditions was also very common. High users of physician services are overwhelmingly characterized by multiple and complex health problems. Policy tools based on a philosophy of deterrence such as cost-sharing are unlikely to have much impact on their costs and will likely do considerable harm.Journal of Health Services Research & Policy 11/2003; 8(4):215-24. · 1.73 Impact Factor
Top co-authors
Top Journals
Institutions
-
2009
-
University of British Columbia - Vancouver
Vancouver, British Columbia, Canada
-
