Patients with high mental health costs incur over 30 per cent more costs than other high-cost patients

Abstract — A small proportion of healthcare users, called high-cost patients, account for a disproportionately large share of healthcare costs. Most literature on these patients has focused on the entire population. However, high-cost patients whose use of mental healthcare services is substantial are likely to differ from other members of the population. We defined a mental health high-cost patient as someone for whom mental health–related services accounted for at least 50 percent of total healthcare costs. We examined these patients’ healthcare utilization and costs in Ontario, Canada. We found that their average cost for healthcare in 2012 was Canadian $31,611. In contrast, the cost was Canadian $23,681 for other high-cost patients. Mental health high-cost patients were younger, lived in poorer neighborhoods, and had different healthcare utilization patterns, compared to other high-cost patients. These findings should be considered when implementing policies or interventions to address quality of care for mental health patients so as to ensure that mental health high-cost patients receive appropriate care in a cost-effective manner. Furthermore, efforts to manage healthcare utilization of mental health patients should address their complex profile through integrated multidisciplinary healthcare delivery.