Hospital Frequent Flyers Small Portion of Population Than Anticipated

Policy makers who are creating initiatives to prevent the very costly and too frequent trips some patients take to the hospital may be examining a population that is actually smaller than they might realize.

In a study published by Health Affairs, researchers found that super-utilizers, or patients who accumulate numerous emergency room visits and hospital admissions over a year span, made up just 3% of the 4774 adults examined in the study. Although they did account for 30% of adult charges.

Less than half of the adults who were characterized as super-utilizers at the start of the study were no longer labeled as such within 7 months from the start. By the end of the year, only 28% of adults in the super-utilizer group were still identified as a hospital frequent flyer. Most patient subgroups reduced their utilization when compared a year later, with the reduction in per person spending averaging 44%.

Of the super-utilizer group, researchers found that 82% of the adults had multiple comorbid chronic conditions, which includes mental health conditions.

“Instability in individual super-utilizer status has important implications for program design,” the authors wrote. “Interventions for individuals who have persistently high utilization are likely to be different from those for individuals with time-limited episodes of super-utilization.”

Recent policy initiatives have been looking to implement community and primary care-based interventions that are less expensive as a means to counter the high costs to the healthcare system super-utilizers are imposing.

“Population-level stability obscures significant instability at the individual level, which may have led to oversimplification of the problem in some policy discussions," the authors wrote.