Small Area Rate Variation in High‐cost Healthcare Use research study underway in Prince Edward Island

In July 2016, the MSSU produced a report examining the nature of health care spending in Nova Scotia. The Small Area Rate Variation (SARV) study found that two‐thirds of health care spending is accounted for by just five percent of health care users (high‐cost users). The SARV study also found that these high‐cost users are geographically clustered in rural and urban communities of the province.

The Prince Edward Island (PEI) node of the MSSU aims to replicate and expand this study using PEI health data. In September 2016, a report was written by the PEI node which examined the drivers of high-cost health care usage on PEI.  The PEI study found that approximately three-quarters of health care spending is accounted for by just five percent of the health care users. These high-cost patients, in the five percent, were significantly more likely to have been diagnosed with a range of chronic conditions in their lifetime. Almost three-quarters of high-cost users have been diagnosed with two or more chronic conditions. In comparison, less than one-third of all other users on PEI, the 95%, had two or more chronic conditions.

Currently, the PEI node of the MSSU is performing analysis to examine if any geographical (SARV), social determinate or other demographics are associated with these high-cost users. The results of this study in PEI may be compared with the results from the other two Maritime provinces and may aid in developing future Maritime initiatives to address these costs.

Analysis of small area variations in rates of health services and outcomes has considerable potential to support health care planning and management by informing targeted high‐yield interventions to reduce costs and improve patient outcomes. SARV may also enable communication of geographic rate variations through easy to understand graphic maps.