- 1Claire de Oliveira ( ) is a health economist in the Social and Epidemiological Research Department at the Centre for Addiction and Mental Health (CAMH), in Toronto, Ontario.
- 2Joyce Cheng is a project coordinator at CAMH.
- 3Simone Vigod is a scientist at Women’s College Hospital, in Toronto.
- 4Jürgen Rehm is director of and a scientist in the Social and Epidemiological Research Department at CAMH.
- 5Paul Kurdyak is director of the Health Outcomes and Performance Evaluation Research Unit at CAMH.
- ↵*Corresponding author
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.