Table 2.
Use and Cost of Prescription Drugs, Physician Services, and Hospital Services per Person in Prescription Drug User Groups, 2011 or Most Recent High‐Cost Year
| Persistent Nonusers | Persistent Low‐Cost Users | Persistent Average‐Cost User | Persistent Moderate‐Cost User | Sporadic Low‐to‐High‐Cost Users | Transition to HCU | Transition from HCU (2011) | Transition from HCU (High‐cost year) | Episodic‐HCU (2011) | Episodic‐HCU (High‐cost year) | Persistent‐HCU | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Prescription drugs | |||||||||||
| Average total cost | $0 | $12 | $131 | $1,587 | $663 | $3,266 | $267 | $2,663 | $255 | $3,485 | $4,192 |
| Median total cost | $0 | $0 | $78 | $1,231 | $612 | $2,020 | $264 | $1,857 | $235 | $1,958 | $2,960 |
| Interquartile range of total costs | ($0, $0) | ($0, $22) | ($12, $205) | ($942, $1,693) | ($337, $857) | ($1,622, $2,925) | ($27, $471) | ($1,579, $2,533) | ($57, $438) | ($1,624, $3,090) | ($2,112, $4,533) |
| Average prescriptions filled | 0.0 | 0.6 | 3.7 | 33.7 | 14.3 | 55.0 | 13.0 | 46.7 | 8.5 | 32.5 | 92.4 |
| Percentage for chronic conditions | – | 38.7 | 69.0 | 92.3 | 86.2 | 93.6 | 90.2 | 92.1 | 83.6 | 87.3 | 95.2 |
| Average days of drug supplied | 0.0 | 8.1 | 133.1 | 1,317.1 | 589.2 | 1,251.8 | 376.3 | 1,203.5 | 290.1 | 750.0 | 2,276.2 |
| Percentage for chronic conditions | – | 56.9 | 88.2 | 96.2 | 94.0 | 94.9 | 94.6 | 94.4 | 92.7 | 90.9 | 96.4 |
| Average number of drug groups | 0.0 | 0.5 | 2.0 | 6.8 | 4.4 | 7.2 | 3.2 | 6.9 | 3.1 | 6.5 | 9.8 |
| Physician services | |||||||||||
| Average total cost | $87 | $172 | $452 | $1,386 | $956a | $1,900 | $909b | $2,094 | $930a,b | $2,094 | $1,999 |
| Median total cost | $0 | $59 | $230 | $911 | $578 | $1,233 | $472 | $998 | $536 | $1,397 | $1,389 |
| Interquartile range of total costs | ($0, $33) | ($0, $189) | ($73, $532) | ($478, $1,693) | ($274, $1,149) | ($644, $2,333) | ($150, $1,059) | ($493, $1,999) | ($212, $1,108) | ($694, $2,677) | ($764, $2,459) |
| Average number of providers | 0.9 | 2.1 | 4.4 | 8.9 | 7.1 | 10.9 | 6.1 | 10.0 | 6.8 | 12.2 | 11.4 |
| Average number of visits | 1.5 | 3.1 | 7.7 | 21.7 | 15.2 | 28.5 | 14.6c | 25.5 | 14.1c | 29.6 | 31.2 |
| Percentage of visits to specialists | 39 | 38 | 41 | 48 | 46 | 51 | 43 | 47 | 49 | 58 | 50 |
| Hospital services | |||||||||||
| Average total cost | $112d | $97d | $333 | $1,915 | $1,130 | $3,525 | $2,489 | $3,230e | $1,404 | $4,151 | $3,264e |
| Median total cost | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Interquartile range of total costs | ($0, $0) | ($0, $0) | ($0, $0) | ($0, $328) | ($0, $0) | ($0, $1,274) | ($0, $0) | ($0, $636) | ($0, $0) | ($0, $3,374) | ($0, $959) |
| Rate of hospitalization | 2 | 4 | 10 | 25 | 19 | 33 | 19 | 29 | 20 | 39 | 33 |
| Hospitalizations per user | 1.3f | 1.1 | 1.2 | 1.5 | 1.4g | 1.7j | 1.4h | 1.6I,j | 1.3f,g,h | 1.8 | 1.7i |
| Percentage of urgent visits | 45 | 23 | 21 | 35 | 29 | 47 | 51 | 48 | 33 | 43 | 45 |
| Length of stay per visit | 5.9 | 2.0 | 2.4 | 4.9 | 4.0 | 6.0 | 10.5 | 7.5 | 5.2 | 5.3 | 5.9 |
| Percentage of day visits | 48 | 68 | 64 | 57 | 60 | 45 | 42 | 59 | 53 | 59 | 49 |
All pairwise differences in measures of average use and cost are statistically significant at p = .001, except as noted with superscript references; for example, a = difference between episodic‐HCUs (in high‐cost year) and persistent moderate‐cost users not significant at p = .001. Costs for episodic‐HCUs and transitions from HCU during their most recent high‐cost year are adjusted for inflation. Drug groups measured using the WHO ATC system, third level, therapeutic/pharmacological subgroup.