A 3-year study of high-cost users of health care (Ontario, Canada) + comparison to U.S. (for those of us who are 'high cost users'

Blogger's Note: (re: highlighted text below) for those following healthcare in Ontario = too late

cmaj - open access (pdf)
January 11, 2016

.....Health care spending per person in any given year is highly uneven. The con­centration of health care utilization among small numbers of patients is well estab­lished. In the United States, the Agency for Healthcare Research and Quality reported that 1% of users in 2008 accounted for 20% of expenditures and that 5% of users accounted for nearly 50% of expenditures.1 Data from Canada in 1972 and 1996, and again in 2009, showed that high-cost users (individuals with the highest 5% of costs) consumed 65% of combined hospi­tal and nursing home costs, 64% of acute care days and 84% of combined acute and post-acute home care resources, respectively.2–4.....

= too late:

 ....The Commission on the Reform of Ontario’s Public Services recommended efficiencies be found in health care for high-cost users in On­tario.12 Finding efficiencies does not necessitate reducing necessary care or total health care spend­ing. Appropriate and high-value care must not be reduced or compromised. Results from our study suggest that causes and solutions vary by age. Re­sults from randomized controlled trials of inte­grated care programs have had success primarily among high-risk older adults.13–16 But integrated care models are expensive and need to be targeted carefully to people who have utilization patterns that would benefit from coordination and integra­tion over time, such as frail older patients with multiple chronic medical and functional impair­ments.