A couple of weeks ago we reported on a couple of Statistical Briefs from the Agency for Healthcare Research and Quality that dealt with the concentration of health spending and out-of-pocket health spending and the persistence of being in the high-spending percentiles. Today we look at a new Statistical Brief which helps us understand what conditions these high-cost individuals have and are being treated for. (Stat. Brief) In 2012 the top 1% in health spending account for 22.7% of all spending, with an annual mean of $97,956, and the top 5% account for over half of all health spending. The top five most costly medical conditions were heart disease at $101 billion, trauma-related disorders (like car accidents) at $92 billion, cancer with $87.5 billion, mental disorders with $84 billion, and COPD/asthma at $76 billion. As we might expect, those persons in the high total spending percentiles account for a significant fraction of the spending in these high-cost conditions.
So for the top 5% of the population that accounts for 50% of total health spending, that group represents 73% of spending on heart disease, or $74 billion in total. Of this top 5% group, 33% had an expenditure related to heart disease, compared to 7% for the population as a whole. For cancer, the top 5% accounted for 82% of all cancer spending, or $72 billion. In comparison, for trauma they represented only 58% of spending and for mental disorders, 41%. Looking at type of health service, for these individuals in the top 5% of total health spending, when they had one of the top five expensive conditions, they tended to have more spending related to inpatient care than the population at large did when one of its members had the same condition. For example, the top 5% had 67% of their spending on heart disease used for inpatient care, while for the general population it was only 58%. These briefs are extremely useful, they give a big picture road map to where spending is and where our effort to control that spending must go.