Characterizing the Senior High Cost User (HCU) in Ontario

NCT02815930 | Unknown

• 1 other identifier: 2016 0760 236 000
• Study Type: observational
• Target: 700,000
• Locations: 0 countries
• Sites: N/A

Brief Summary

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

Conditions

Senior High Cost Users (HCU)

Keywords

High cost user (HCU); Healthcare utilization; Healthcare expenditures; Medication use; Medication expenditures; Multimorbidity; Observational study

Outcome Measures

Primary Outcomes (3)

• Total healthcare expenditures per patient

  1 year after index date

• Total drug costs per patient

  1 year after index date

• Drug cost to total healthcare expenditure ratio

  1 year after index date

Secondary Outcomes (2)

• All-cause mortality

  1 year after index date

• All-cause hospitalization rate

  1 year after index date

Study Arms (2)

HCUs

Newly incident seniors with annual total healthcare expenditures in the top 5% of Ontarians

Other: HCU Status

Non-HCUs

Seniors with annual total healthcare expenditures below the top 5% of Ontarians

Interventions

HCU Status OTHER

Total healthcare expenditures in the top 5% of Ontarians

HCUs

Eligibility Criteria

• Age: 66 Years - 105 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Newly incident senior high cost users (HCUs) in Ontario

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• McMaster University: lead
• Ontario Drug Policy Research Network (ODPRN): collaborator
• Research Institute of St. Joseph's Hamilton: collaborator

Related Publications (1)

• Lee J, Muratov S, Tarride JE, Paterson JM, Thavorn K, Mbuagbaw L, Gomes T, Khuu W, Seow H, Thabane L, Holbrook A. Medication use and its impact on high-cost health care users among older adults: protocol for the population-based matched cohort HiCOSTT study. CMAJ Open. 2021 Jan 11;9(1):E44-E52. doi: 10.9778/cmajo.20190196. Print 2021 Jan-Mar.

  PMID: 33436455 DERIVED

Study Officials

• Justin Lee, BScPhm, ACPR, MD, FRCPC

  McMaster University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 24, 2016
• First Posted: June 28, 2016
• Study Start: April 1, 2012
• Primary Completion: March 1, 2014
• Study Completion: December 1, 2020
• Last Updated: February 5, 2020

Record last verified: 2019-03