OBJECTIVES : To describe the demographic characteristics and Health Resources Utilization of multi-consultant patients in a Colombian insurer

METHODS : a database with health cost was used to identify the patients (excluding women in pregnancy) with more than 5 consultations of general practitioner or specialized medicine from January 2018 through May 2018 (multi-consultant patients). The patient’s total consumption cost was pulled out and analyzed separately into 2 categories: ambulatory (without medication) and hospitalization. Characterization of demographic and clinical variables was carried out and an income-cost relationship was also calculated

RESULTS : A total of 3.988 (5.86%) patients were identified out of the total patients who consumed health services within this period. The sex ratio for multi-consultant patients is of 1 man every 2.6 woman and the average age is 47,41. Multi-consultant patients account for 19.9% of the total consultations for general practitioner and specialized medicine; within this 19.9%, 80% are for general practitioner and 20% for specialized medicine. Furthermore, 55% of the outpatient visits have a diagnosis for chronic pathologies and 45% for non-chronic pathologies. The average health resources utilized per patient per month were 1.6 consultations (general practitioner and specialized medicine), 2.06 procedures (surgical and non-surgical) and a hospitalization rate of 3.8%. Compared to the total patients who consulted within this period, the HRU per patient per month are 0.60 for consultations, 0.91 for procedures and 1.18% for hospitalization. Moreover, the loss ratio for these patients is 225%, meaning they utilize 2.25 times more the resources they are assigned with for their coverage

CONCLUSIONS : Multi-consultant patients represent a small percentage among all affiliates, however, they consume an important amount of services and resources. They are in its great majority female adults who consume more than twice the income assigned to them. The diseases multi-consultant patients are diagnosed with are higher for chronic than for non-chronic pathologies.