Characteristics and risk factors associated with high-cost Medicaid recipients.
Characteristics and risk factors of fee-for-service Medicaid patients (age < 65 yr) with high health care costs were assessed by analyzing Ohio's Medicaid claims database. High-cost recipients were defined as those with average monthly Medicaid expenses at or above the 90th percentile. The records of 10,582 high-cost patients and 11,045 comparison patients were examined for clinical comorbidity, mortality status, enrollment, and demographic factors, using logistic and logarithmic multiple regression. Researchers found that a Medicaid recipient had the greatest odds of being in the following groups: dying (odds ratio = 4.0), disabled (2.2), urban resident (1.8), and male (1.3). They concluded that state and federal efforts to control Medicaid expenditures should focus on those high-costrecipients and examine their service utilization.
Guo
Jeff J
JJ
College of Pharmacy, University of Cincinnati, Ohio 45267-0004, USA. jeff.guo@uc.edu
Ludke
Robert L
RL
Heaton
Pamela C
PC
Moomaw
Charles J
CJ
Ho
Mona
M
Cluxton
Robert J
RJ
D000328:Adult; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009820:Ohio; D012307:Risk Factors; D014481:United States