Population health management
-
Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. ⋯ When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole.
-
In the United States, patient usage of costly emergency departments (EDs) has been portrayed as a major factor contributing to health care expenditures. The homeless are associated with ED frequent users, a population often blamed for inappropriate ED use. This study examined the characteristics and costs associated with homeless ED frequent users. ⋯ ED frequent users are disproportionately homeless and their costs are significant. ED discharge planning should address the additional risks faced by homeless individuals. ED-based interventions that specifically target the most expensive homeless frequent users may prove to be cost-effective.