In a report whose substance would probably be roughly replicated in other states, a Pennsylvania state panel reports that 3 percent of hospitalized patients in Pennsylvania consume a huge proportion of healthcare resources and at a huge total cost: about $1.25 billion a year.
These “superusers” — patients with five or more hospital admissions per year— accounted for 10 percent of all hospital payments in 2016, according to a new report (PDF) by the Pennsylvania Health Care Cost Containment Council (PHC4). They account for 12 percent of hospital admissions and 15 percent of hospital days.
Eighty percent of those payments were for Medicare and/or Medicaid patients.
The three biggest reasons for superusers’ frequent hospital stays were sepsis, heart failure and mental-health disorders. The last, of course, tend to be linked with other ailments. Consider the higher than average incidence of alcoholism, drug addiction and smoking by mentally ill people “medicating” themselves. These pathologies, of course cause many other ailments, especially various cancers and heart and circulatory ailments. And then there are the traffic and other accidents associated with addiction.
Still, there was a ray of good news: The number of superusers dropped to 21,968 in 2016 from 24,045 in 2012.
Robert Shipp III, vice president for population health strategies for the Hospital and Health System Association of Pennsylvania, told The Philadelphia Inquirer that Keystone State hospitals have moved to address the superuser problem by, for example advising such patients to visit their primary-care provider, not a hospital, for follow-up care. And increasingly nurses and pharmacists are checking up on patients by phone and visiting them at home.
“Organizations across the country have tried to tackle the problem of high-cost superusers. When the University of Illinois Hospital noticed that its most frequent superusers were chronically homeless patients, it launched an initiative to provide them with furnished apartments and support services. The organization’s $250,000 investment in the program has resulted in a 35% drop in monthly hospital visits and a 40% decrease in the annual cost of their care.”
To read the Pennsylvania panel’s report, please hit this link.
To read The Philadelphia Inquirer’s story, please hit this link.
To read FierceHealthcare’s comment, please hit this link.