Patients With High Mental Health Costs Incur Over 30 Percent More Costs Than Other High-Cost Patients

Health Aff (Millwood). 2016 Jan;35(1):36-43. doi: 10.1377/hlthaff.2015.0278.


A small proportion of health care users, called high-cost patients, account for a disproportionately large share of health care costs. Most literature on these patients has focused on the entire population. However, high-cost patients whose use of mental health care services is substantial are likely to differ from other members of the population. We defined a mental health high-cost patient as someone for whom mental health-related services accounted for at least 50 percent of total health care costs. We examined these patients' health care utilization and costs in Ontario, Canada. We found that their average cost for health care, in 2012 Canadian dollars, was $31,611. In contrast, the cost was $23,681 for other high-cost patients. Mental health high-cost patients were younger, lived in poorer neighborhoods, and had different health care utilization patterns, compared to other high-cost patients. These findings should be considered when implementing policies or interventions to address quality of care for mental health patients so as to ensure that mental health high-cost patients receive appropriate care in a cost-effective manner. Furthermore, efforts to manage mental health patients' health care use should address their complex profile through integrated multidisciplinary health care delivery.

Keywords: Cost of Health Care; Mental Health/Substance Abuse.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cost-Benefit Analysis
  • Databases, Factual
  • Female
  • Health Care Costs*
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / economics*
  • Mental Disorders / therapy
  • Mental Health / economics*
  • Mental Health Services / economics*
  • Middle Aged
  • Ontario
  • Risk Assessment
  • Rural Population
  • Sex Factors
  • Urban Population
  • Vulnerable Populations
  • Young Adult