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- W3111512348 abstract "This study aims to evaluate annual healthcare spending by a German sickness fund, and to analyze the distribution of costs incurred by members of the public insurance population in 2018. Costs were analyzed using claims data from a German statutory health insurance fund (AOK PLUS) for the year 2018. Data included costs related to inpatient care and outpatient care, including respective medications and surgeries, as well as cost of aids and remedies that have been reimbursed by the sickness fund. All patients with continuous insurance (except death) from AOK PLUS for the period 01/01/2018-31/12/2018 were included in the analysis. The claims dataset included 3,061,982 individuals (52.52% female) with a mean age of 47.00 years; 1.68% of patients died within the observational year. Average annual healthcare spending per person was €2,837 (median: €923), with 48.59% of total costs incurred for outpatient care and medications (mean/median: €1,378/€729), 42.25% for inpatient care (including medications) (mean/median: €1,198/0€), and 9.16% for aids and remedies (mean/median: €260/€0). Around 5.72% of the insured patient population did not incur any costs in 2018, while 5.93% of patients incurred expenses greater than €10,000. Patients in the highest spending quintile accounted for 74.76% of all healthcare-related costs in 2018; this translates into an average annual cost of €10,630 per person. Similarly, the most costly patients at the 10%/5%/1% levels accounted for 59.12%/44.33%/19.43% of annual healthcare spending (i.e. €16,768/€10,630€/€25,146/€55,122 per patient). The distribution of healthcare spending is highly skewed with a minority of insured persons causing the majority of costs. In order to improve the cost-effectiveness of the healthcare system, it is of utmost importance to identify and characterize patients who drive healthcare costs, as well as the sectors and interventions that are triggering high healthcare spending." @default.
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- W3111512348 date "2020-12-01" @default.
- W3111512348 modified "2023-10-14" @default.
- W3111512348 title "PMU8 Health Care Spending And The Pareto Principle - The Minority That Causes The Majority" @default.
- W3111512348 doi "https://doi.org/10.1016/j.jval.2020.08.1220" @default.
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