New Methods for Evaluation of High-utilizing patients


To identify and analyse high utilisers is a highly relevant topic for the Austrian social security institutions. Identification (and prediction) of high utilisers is the starting point of an active individual health care approach to capture and prioritise vulnerable insured persons (from the approach of determinants to the interventional approach). Without taking into account the issue of costs, the focus of high-utilising patients lies on the provision of care and can be used to develop specific interventions for the identified populations and to achieve better health care outcomes in this population group.


Already developed methods can be used to identify high utilisers¹. Therefore, their identification is possible concerning to a disproportional high usage of care which is based on the number of services and contacts in the ambulatory sector as well as the number of days spent in the hospital sector (where at least two out of these three characteristics are applicable). People are identified as high utilisers per calendar year.

In order to be able to observe time series, we use a longitudinal-design (2006 to 2011).

High utilisers can be distinguished according to their different characteristic forms, depending on the fact whether they have been a high utiliser for one year or for several years or throughout the whole observational period.

According to the research questions, longitudinal analyses are required to observe people over time. Analysis can be used for comparing high utilisers with non-high utilisers, and for comparing different high utiliser subgroups among themselves over time.