Expenditure variations analysis using residuals for identifying high health care utilizers in a state Medicaid program

Table 5 Comparison of demographics, health conditions and health care utilization of high utilizers (top 5%) with other patients, 2014

Characteristics	High Utilizers (High Residuals)	Other Patients
Number of Patients	26,771	508,652
Demographics
Mean age (years)	34.11	35.22
Sex
Female, %	58.49	68.47
Race
White, non-Hispanic, %	23.22	26.44
Black, non-Hispanic, %	19.04	21.82
Hispanic, %	40.10	37.39
American Indian or Alaskan, %	0.18	0.19
Asian, Pacific Islander, %	2.08	1.57
Unknown/Other, %	15.38	12.60
Disabled, %	51.45	45.32
Health Conditions
Charlson Comorbidity Index [26]	1.66	1.61
Mental illness [9], %	41.49	48.04
Substance use [9], %	29.15	34.00
Utilization
Average total medical expenditures, $	19,531.87	6588.32
Average professional expenditures^†, $	4937.37	2184.88
Average institutional expenditures^‡, $	7215.62	2450.32
Average pharmacy expenditures, $	7338.35	1940.62
Average number of emergency department visits	0.47	1.03
Average number of inpatient hospital visits	0.38	0.20

^†Professional expenditures represent paid claims generated for work performed by physicians, suppliers, and other non-institutional providers for all medical services
^‡Institutional expenditures represent paid claims generated for work performed by hospitals, skilled nursing facilities, and other institutions for all medical services

ISSN: 1472-6947