Characterizing the Senior High Cost User in Ontario: A Population-Based Matched Cohort Study
试验速览
- 阶段
- 不适用
- 入组人数
- 700,000
- 主要终点
- Total drug costs per patient
研究概览
简要总结
High cost users (HCUs) are a small group of patients who use a disproportionate amount of health care resources. This study is a retrospective population-based matched cohort analysis of newly incident senior High Cost Users (HCUs) defined as Ontarians aged 66 years or older in the top 5% of healthcare expenditure users in fiscal year 2013 (FY2013). The study objectives are to characterize and contrast Ontario senior HCUs to non-HCUs based on their demographics, co-morbidities, medication use, health service utilization, healthcare expenditures, medication costs and clinical outcomes, and to determine the relative contribution of medications to senior HCUs expenditures
详细描述
Senior high cost users (HCUs) with annual healthcare expenditures within the top 5% of Ontarians will be identified using established ICES costing algorithms. This cohort will be matched to a cohort of non-HCUs using a 3:1 matching ratio (non-HCU to HCU) based on age at cohort entry (+/- 1 month), sex and geographic location of residence (based on LHIN) for comparative analysis. Descriptive statistics will be used to describe the study populations and outcomes. Regression analyses will be used to adjust for potential confounders when analyzing healthcare resource utilization and costs as a function of HCU status (e.g. income, type of residence, co-morbidities, rural/urban) and/or when analyzing sub-populations [e.g. chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF)]. Logistic regression will be performed using the patient level data to predict the impact of individual factors on the likelihood of becoming a senior HCU.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 66 Years 至 105 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Ontario residents registered in RPDB between April 1, 2013 - March 31, 2014
- •Annual total health care expenditures in FY2013 equal to or greater than financial threshold for the top 5% of all Ontarians
排除标准
- •Death on OR prior to index date
- •Age > 105
- •Annual total health care expenditures in FY2012 fiscal year greater than financial threshold of 5% of all Ontarians in FY2013
结局指标
主要结局
Total drug costs per patient
时间窗: 1 year after index date
Total healthcare expenditures per patient
时间窗: 1 year after index date
Drug cost to total healthcare expenditure ratio
时间窗: 1 year after index date
次要结局
- All-cause mortality(1 year after index date)
- All-cause hospitalization rate(1 year after index date)