title: Frequency and clinical description of high-cost patients in 17 acute-care hospitals.
abstract: To assess the potential impact of national "catastrophic" health insurance on the medical-care system, the frequency and clinical characteristics of high-cost patients were surveyed at 17 acute-care hospitals in the San Francisco Bay Area. The percentage of patients whose yearly hospital charges exceeded $4000 in 1976 ranged from 4 at a community hospital to 24 at a referral hospital. Hospital costs charged to these patients ranged from 20 to 68 per cent of total billings, with the highest percentages generally occurring at large referral hospitals. Forty-seven per cent of adult high-cost patients had chronic medical conditions, and only one in six suffered from an acute medical "catastrophe." In addition, more than 13 per cent of high-cost patients died in the hospital. National catastrophic health insurance is likely to pay for much chronic illness and terminal care and divert resources toward acute-care hospitals.
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D002140:California; D003365:Costs and Cost Analysis; D004469:Economics, Hospital; D005260:Female; D006763:Hospitals, Chronic Disease / Q000191:economics; D006764:Hospitals, Community / Q000191:economics; D006766:Hospitals, County / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009310:National Health Insurance, United States / Q000191:economics; D010361:Patients; D012737:Sex Factors; D014481:United States