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High-cost health care users in Ontario, Canada: demographic, socio-economic, and health status characteristics

Overview of attention for article published in BMC Health Services Research, October 2014
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

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1 policy source
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15 X users
facebook
1 Facebook page

Citations

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138 Dimensions

Readers on

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237 Mendeley
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1 CiteULike
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Title
High-cost health care users in Ontario, Canada: demographic, socio-economic, and health status characteristics
Published in
BMC Health Services Research, October 2014
DOI 10.1186/s12913-014-0532-2
Pubmed ID
Authors

Laura C Rosella, Tiffany Fitzpatrick, Walter P Wodchis, Andrew Calzavara, Heather Manson, Vivek Goel

Abstract

BackgroundHealth care spending is overwhelmingly concentrated within a very small proportion of the population, referred to as the high-cost users (HCU). To date, research on HCU has been limited in scope, focusing mostly on those characteristics available through administrative databases, which have been largely clinical in nature, or have relied on ecological measures of socio-demographics. This study links population health surveys to administrative data, allowing for the investigation of a broad range of individual-level characteristics and provides a more thorough characterization of community-dwelling HCU across demographic, social, behavioral and clinical characteristics.MethodsWe linked three cycles of the Canadian Community Health Survey (CCHS) to medical claim data for the years 2003¿2008 for Ontario, Canada. Participants were ranked according to gradients of cost (Top 1%, Top 2-5%, Top 6-50% and Bottom 50%) and multinomial logistic regression was used to investigate a wide range of factors, including health behaviors and socio-demographics, likely associated with HCU status.ResultsUsing a total sample of 91,223 adults (18 and older), we found that HCU status was strongly associated with being older, having multiple chronic conditions, and reporting poorer self-perceived health. Specifically, in the fully-adjusted model, poor self-rated health (vs. good) was associated with a 26-fold increase in odds of becoming a Top 1% HCU (vs. Bottom 50% user) [95% CI: (18.9, 36.9)]. Further, HCU tended to be of lower socio-economic status, former daily smokers, physically inactive, current non-drinkers, and obese.ConclusionsThe results of this study have provided valuable insights into the broader characteristics of community-dwelling HCU, including unique demographic and behavioral characteristics. Additionally, strong associations with self-reported clinical variables, such as self-rated general and mental health, highlight the importance of the patient perspective for HCU. These findings have the potential to inform policies for health care and public health, particularly in light of increasing decision-maker attention in the sustainability of the health care system, improving patient outcomes and, more generally, in order to achieve the common goal of improving population health outcomes.

X Demographics

X Demographics

The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 237 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 4 2%
Unknown 233 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 47 20%
Researcher 41 17%
Student > Bachelor 27 11%
Student > Ph. D. Student 24 10%
Other 12 5%
Other 47 20%
Unknown 39 16%
Readers by discipline Count As %
Medicine and Dentistry 67 28%
Nursing and Health Professions 28 12%
Social Sciences 23 10%
Psychology 10 4%
Economics, Econometrics and Finance 10 4%
Other 36 15%
Unknown 63 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 June 2022.
All research outputs
#2,387,765
of 25,081,505 outputs
Outputs from BMC Health Services Research
#959
of 8,506 outputs
Outputs of similar age
#26,868
of 267,064 outputs
Outputs of similar age from BMC Health Services Research
#20
of 169 outputs
Altmetric has tracked 25,081,505 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,506 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 267,064 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 169 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.