Patients who require the highest levels of health care resources are increasingly becoming a significant focus of worldwide health research, as many regions struggle to provide high-quality care with limited resources and growing costs. Research consistently reports that a disproportionate share of health care costs are attributed to a small patient population.
Most research to date has used administrative data to quantitatively characterize subgroups and respective resource use patterns in high-resource patients (HRPs) with the aim of improving health system efficiency and effectiveness. However, very few studies have included HRPs’ perspectives and lived experiences, or health care providers’ perspectives, who provide care within these systems. While decision makers value the rich information and context provided by these perspectives, they often struggle with incorporating qualitative evidence into policy and practice.
Using administrative data, our Phase 1 study identified a cohort of patients in Prince Edward Island, who accounted for almost three-quarters of health care expenditures despite representing only five percent of the adult population. We found that high resource health care use (HRHCU) was linked with the level of social and material deprivation in a patient’s neighborhood level and a patient’s chronic disease status. While these results uncover trends in HRHCU in PEI, they do not provide an understanding of causality. The barriers and gaps in care that affect these patients and result in HRHCU also remain unexplored. The objectives of our current project are twofold:
- to gain an in-depth and first-hand understanding of the issues faced by the high-resource patient population and
- to aid decision makers in using these qualitative findings to improve costs, care and outcomes.
This research will inform decision makers and care providers on how to more effectively provide care and supports for these patients, improving health outcomes and quality of life. A reduction in spending for this small proportion of the population also stands to improve the health care system for all Islanders through the reinvestment of these dollars into additional health care services. These findings may also help direct further research and decision making in other jurisdictions.