Table 1.
Patient characteristics for each of the utilizer groups, presented as median (IQR) or frequency (%)
| Commercial | |||||
|---|---|---|---|---|---|
| Total n = 5666 |
Low-utilizers n = 2833 |
Moderate-utilizers n = 1417 |
High-utilizers n = 850 |
Super-utilizers n = 566 |
|
| Patient years | 3.0 (2-5) | 3.3 (2-5) | 3.0 (2-5) | 2.9 (1.8-4.5) | 2.8 (1.7-4.1) |
| Age, y | 32 (22-44) | 34 (22-45) | 32 (22-44) | 31 (21-42) | 28 (19-42) |
| Female | 3389 (59.8%) | 1672 (59.0%) | 892 (62.9%) | 505 (59.4%) | 320 (56.5%) |
| Region | |||||
| Northeast | 1115 (19.7%) | 548 (19.3%) | 275 (19.4%) | 171 (20.1%) | 121 (21.4%) |
| North Central | 751 (13.3%) | 365 (12.9%) | 200 (14.1%) | 121 (14.2%) | 65 (11.5%) |
| South | 3477 (61.4%) | 1769 (62.4%) | 863 (60.9%) | 510 (60.0%) | 335 (59.2%) |
| West | 307 (5.4%) | 143 (5.0%) | 75 (5.3%) | 45 (5.3%) | 44 (7.8%) |
| Unknown | 16 (0.3%) | 8 (0.3%) | 4 (0.3%) | 3 (0.4%) | 1 (0.2%) |
| SCD genotype | |||||
| Hb SS | 2457 (43.4%) | 797 (28.1%) | 733 (51.7%) | 530 (62.4%) | 397 (70.1%) |
| Hb SC | 1179 (20.8%) | 739 (26.1%) | 268 (18.9%) | 120 (14.1%) | 52 (9.2%) |
| Hb Sβ+/0 | 627 (11.1%) | 343 (12.1%) | 154 (10.9%) | 83 (9.8%) | 47 (8.3%) |
| Nonspecific | 1403 (24.8%) | 954 (33.7%) | 262 (18.5%) | 117 (13.8%) | 70 (12.4%) |
| CCI | 0 (0-1) | 0 (0-1) | 0 (0-2) | 1 (0-2) | 2 (1-4) |
| SCD-related comorbidity | |||||
| CVD | 624 (11.0%) | 118 (4.2%) | 170 (12.0%) | 164 (19.3%) | 172 (30.4%) |
| CHF | 543 (9.6%) | 83 (2.9%) | 129 (9.1%) | 150 (17.6%) | 181 (32.0%) |
| PH | 487 (8.6%) | 98 (3.5%) | 129 (9.1%) | 133 (15.6%) | 127 (22.4%) |
| RD | 536 (9.5%) | 122 (4.3%) | 123 (8.7%) | 127 (14.9%) | 164 (29.0%) |
| Medicare | |||||
|---|---|---|---|---|---|
| Total n = 8600 |
Low-utilizers n = 4300 |
Moderate-utilizers n = 2150 |
High-utilizers n = 1290 |
Super-utilizers n = 860 |
|
| Patient years | 4.5 (3.0-4.9) | 4.5 (3.4-4.8) | 4.7 (3.2-4.9) | 4.6 (2.8-4.9) | 3.2 (1.8-4.9) |
| Age, y | 39 (29-53) | 41 (30-56) | 36 (28-51) | 37 (28-51) | 38 (28-52) |
| Female | 4985 (58.0%) | 2564 (59.6%) | 1202 (55.9%) | 742 (57.5%) | 477 (55.5%) |
| Race | |||||
| White | 401 (4.7%) | 211 (4.9%) | 93 (4.3%) | 62 (4.8%) | 35 (4.1%) |
| Black | 7621 (88.6%) | 3808 (88.6%) | 1903 (88.5%) | 1140 (88.4%) | 770 (89.5%) |
| Other/unknown | 578 (6.7%) | 281 (6.5%) | 154 (7.2%) | 88 (6.8%) | 55 (6.4%) |
| Region | |||||
| Midwest | 1432 (16.7%) | 742 (17.3%) | 354 (16.5%) | 192 (14.9%) | 144 (16.7%) |
| Northeast | 1323 (15.4%) | 653 (15.2%) | 336 (15.6%) | 215 (16.7%) | 119 (13.8%) |
| South | 5159 (60.0%) | 2575 (59.9%) | 1269 (59.0%) | 786 (60.9%) | 529 (61.5%) |
| West | 686 (8.0%) | 330 (7.7%) | 191 (8.9%) | 97 (7.5%) | 68 (7.9%) |
| SCD genotype | |||||
| Hb SS | 5590 (65.0%) | 2407 (56.0%) | 1577 (73.3%) | 943 (73.1%) | 663 (77.1%) |
| Hb SC | 928 (10.8%) | 646 (15.0%) | 165 (7.7%) | 77 (6.0%) | 40 (4.7%) |
| HB Sβ+/0 | 643 (7.5%) | 383 (8.9%) | 133 (6.2%) | 78 (6.0%) | 49 (5.7%) |
| Nonspecific | 1439 (16.7%) | 864 (20.1%) | 275 (12.8%) | 192 (14.9%) | 108 (12.6%) |
| CCI | 1 (0-3) | 0 (0-1) | 1 (0-3) | 3 (1-5) | 4 (2-6) |
| SCD-related comorbidity | |||||
| CVD | 1232 (14.3%) | 321 (7.5%) | 366 (17.0%) | 269 (20.9%) | 276 (32.1%) |
| CHF | 2234 (26.0%) | 485 (11.3%) | 627 (29.2%) | 602 (46.7%) | 520 (60.5%) |
| PH | 1923 (22.4%) | 397 (9.2%) | 591 (27.5%) | 514 (39.8%) | 421 (49.0%) |
| RD | 2341 (27.2%) | 564 (13.1%) | 613 (28.5%) | 635 (49.2%) | 529 (61.5%) |
| Dual eligible | 5552 (64.6%) | 2504 (58.2%) | 1497 (69.6%) | 914 (70.9%) | 637 (74.1%) |
Low-utilizers: bottom 50% of costs; moderate-utilizers: top 25% to 49.9% of costs; high-utilizers: top 10% to 24.9% of costs; super-utilizers: top 10% of costs.
CHF, congestive heart failure; CVD, cerebrovascular disease; Hb SS: hemoglobin SS; Hb SC, hemoglobin SC; HB Sβ+/0, hemoglobin Sβ+/0 thalassemia; IQR, interquartile range; PH, pulmonary hypertension; RD, renal disease.