This resource assesses the characteristics and health care utilization of high-cost patients and compares high-cost patients across payers and countries, based on a systematic review of studies in PubMed and Embase databases. It adds further data for the importance of segmentation and relevant strata.
- The studies pointed to a high prevalence of multiple (chronic) conditions to explain high-cost patients’ utilization.
- There was a high prevalence of mental illness across all studies.
- High costs were associated with higher incomes in the USA but with lower incomes elsewhere.
- Preventable spending was estimated at maximally 10% of spending.
- High-cost patients are diverse populations and vary across payer types and countries. Tailored interventions are needed to meet the needs of high-cost patients and to avoid wasting resources.