ArticleCanadian journal of public health = Revue canadienne de sante publique2018
The effect of socio-demographic factors on mental health and addiction high-cost use: a retrospective, population-based study in Saskatchewan.
Article in Canadian journal of public health = Revue canadienne de sante publique, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- When Policy Meets Reality: Municipal Leaders' Views Amid Rising LTC Expenditure.Health services insights · 2026Article
- Evaluating the impact of financial worry on mental health: a cross-sectional study among Kenyan radiographers.BMC public health · 2024Article
- Assessing differences among persistent, episodic, and non- high-need high-cost hospitalized children in China after categorization by an unsupervised learning algorithm.Archives of public health = Archives belges de sante publique · 2024Article
- Creating an 11-year longitudinal substance use harm cohort from linked health and census data to analyse social drivers of health.International journal of population data science · 2024Article
- Cost structure in specialist mental healthcare: what are the main drivers of the most expensive episodes?International journal of mental health systems · 2023Article
- Inequities in Rural and Urban Health Care Utilization Among Individuals Diagnosed With Inflammatory Bowel Disease: A Retrospective Population-Based Cohort Study From Saskatchewan, Canada.Journal of the Canadian Association of Gastroenterology · 2023Article
- Increasing Prevalence and Direct Health Care Cost of Inflammatory Bowel Disease Among Adults: A Population-Based Study From a Western Canadian Province.Journal of the Canadian Association of Gastroenterology · 2021Article
- Population-Based Evidence From a Western Canadian Province of the Decreasing Incidence Rates and Trends of Inflammatory Bowel Disease Among Adults.Journal of the Canadian Association of Gastroenterology · 2021Article
- "People just don't understand their role in it." Collaboration and coordination of care for service users with complex and severe mental health problems.Perspectives in psychiatric care · 2020Article
- Modeling socio-demographic and clinical factors influencing psychiatric inpatient service use: a comparison of models for zero-Inflated and overdispersed count data.BMC medical research methodology · 2020Article
- Use of the Population Grouping Methodology of the Canadian Institute for Health Information to predict high-cost health system users in Ontario.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- Defining 'actionable' high- costhealth care use: results using the Canadian Institute for Health Information population grouping methodology.International journal for equity in health · 2019Article
- Longitudinal Cost of Services in a Homeless Sample with Cocaine Use Disorder.Journal of social distress and the homeless · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
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.
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