Morbidity and doctor characteristics only partly explain the substantial healthcare expenditures of frequent attenders: a record linkage study between patient data and reimbursements data
Background Frequently attending patients to primary care (FA) are likely to cost more in primary care than their non-frequently attending counterparts. But how much is spent on specialist care of FAs? We describe the healthcare expenditures of frequently attending patients during 1, 2 or 3 years and test the hypothesis that additional costs can be explained by FAs’ combined morbidity and primary care physicians’ characteristics. Methods Record linkage study. Pseudonymised clinical data from the medical records of 16 531 patients from 39 general practices were linked to healthcare insurer’s reimbursements data. Main outcome measures were all reimbursed primary and specialist healthcare costs between 2007 and 2009. Multilevel linear regression analysis was used to quantify the effects of the different durations of frequent attendance on three-year total healthcare expenditures in primary and specialist care, while adjusting for age, sex, morbidities and for primary care physicians characteristics. Primary care physicians’ characteristics were collected through administrative data and a questionnaire. Results Unadjusted mean 3-year expenditures were 5044 and 15 824 Euros for non-FAs and three-year-FAs, respectively. After adjustment for all other included confounders, costs both in primary and specialist care remained substantially higher and increased with longer duration of frequent attendance. As compared to non-FAs, adjusted mean expenditures were 1723 and 5293 Euros higher for one-year and three-year FAs, respectively. Conclusions FAs of primary care give rise to substantial costs not only in primary, but also in specialist care that cannot be explained by their multimorbidity. Primary care physicians’ working styles appear not to explain these excess costs. The mechanisms behind this excess expenditure remain to be elucidated..
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2013 |
---|---|
Erschienen: |
2013 |
Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
---|---|
Enthalten in: |
BMC family practice - 14(2013), 1 vom: 17. Sept. |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Smits, Frans T [VerfasserIn] |
---|
Links: |
Volltext [kostenfrei] |
---|
Themen: |
(Persisting) frequent attender |
---|
Anmerkungen: |
© Smits et al.; licensee BioMed Central Ltd. 2013 |
---|
doi: |
10.1186/1471-2296-14-138 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
SPR02738876X |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | SPR02738876X | ||
003 | DE-627 | ||
005 | 20230519182316.0 | ||
007 | cr uuu---uuuuu | ||
008 | 201007s2013 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/1471-2296-14-138 |2 doi | |
035 | |a (DE-627)SPR02738876X | ||
035 | |a (SPR)1471-2296-14-138-e | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Smits, Frans T |e verfasserin |4 aut | |
245 | 1 | 0 | |a Morbidity and doctor characteristics only partly explain the substantial healthcare expenditures of frequent attenders: a record linkage study between patient data and reimbursements data |
264 | 1 | |c 2013 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a Computermedien |b c |2 rdamedia | ||
338 | |a Online-Ressource |b cr |2 rdacarrier | ||
500 | |a © Smits et al.; licensee BioMed Central Ltd. 2013 | ||
520 | |a Background Frequently attending patients to primary care (FA) are likely to cost more in primary care than their non-frequently attending counterparts. But how much is spent on specialist care of FAs? We describe the healthcare expenditures of frequently attending patients during 1, 2 or 3 years and test the hypothesis that additional costs can be explained by FAs’ combined morbidity and primary care physicians’ characteristics. Methods Record linkage study. Pseudonymised clinical data from the medical records of 16 531 patients from 39 general practices were linked to healthcare insurer’s reimbursements data. Main outcome measures were all reimbursed primary and specialist healthcare costs between 2007 and 2009. Multilevel linear regression analysis was used to quantify the effects of the different durations of frequent attendance on three-year total healthcare expenditures in primary and specialist care, while adjusting for age, sex, morbidities and for primary care physicians characteristics. Primary care physicians’ characteristics were collected through administrative data and a questionnaire. Results Unadjusted mean 3-year expenditures were 5044 and 15 824 Euros for non-FAs and three-year-FAs, respectively. After adjustment for all other included confounders, costs both in primary and specialist care remained substantially higher and increased with longer duration of frequent attendance. As compared to non-FAs, adjusted mean expenditures were 1723 and 5293 Euros higher for one-year and three-year FAs, respectively. Conclusions FAs of primary care give rise to substantial costs not only in primary, but also in specialist care that cannot be explained by their multimorbidity. Primary care physicians’ working styles appear not to explain these excess costs. The mechanisms behind this excess expenditure remain to be elucidated. | ||
650 | 4 | |a (Persisting) frequent attender |7 (dpeaa)DE-He213 | |
650 | 4 | |a High utilizer |7 (dpeaa)DE-He213 | |
650 | 4 | |a Healthcare expenditure |7 (dpeaa)DE-He213 | |
650 | 4 | |a Primary care |7 (dpeaa)DE-He213 | |
650 | 4 | |a General practice |7 (dpeaa)DE-He213 | |
650 | 4 | |a Primary care physician |7 (dpeaa)DE-He213 | |
650 | 4 | |a General practitioner |7 (dpeaa)DE-He213 | |
650 | 4 | |a Linkage study |7 (dpeaa)DE-He213 | |
650 | 4 | |a Reimbursements data |7 (dpeaa)DE-He213 | |
650 | 4 | |a Multimorbidity |7 (dpeaa)DE-He213 | |
700 | 1 | |a Brouwer, Henk J |4 aut | |
700 | 1 | |a Zwinderman, Aeilko H |4 aut | |
700 | 1 | |a Mohrs, Jacob |4 aut | |
700 | 1 | |a Smeets, Hugo M |4 aut | |
700 | 1 | |a Bosmans, Judith E |4 aut | |
700 | 1 | |a Schene, Aart H |4 aut | |
700 | 1 | |a Van Weert, Henk C |4 aut | |
700 | 1 | |a ter Riet, Gerben |4 aut | |
773 | 0 | 8 | |i Enthalten in |t BMC family practice |d London : BioMed Central, 2000 |g 14(2013), 1 vom: 17. Sept. |w (DE-627)SPR027378632 |w (DE-600)2041495-X |x 1471-2296 |7 nnns |
773 | 1 | 8 | |g volume:14 |g year:2013 |g number:1 |g day:17 |g month:09 |
856 | 4 | 0 | |u https://dx.doi.org/10.1186/1471-2296-14-138 |z kostenfrei |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_SPRINGER | ||
912 | |a SSG-OLC-PHA | ||
951 | |a AR | ||
952 | |d 14 |j 2013 |e 1 |b 17 |c 09 |