Identifying patterns of clinical conditions among high-cost older adult health care users using claims data: a latent class approach

To identify patterns of clinical conditions among high-cost older adults health care users and explore the associations between characteristics of high-cost older adults and patterns of clinical conditions. We analyzed data from the Shanghai Basic Social Medical Insurance Database, China. A total of 2927 older adults aged 60 years and over were included as the analysis sample. We used latent class analysis to identify patterns of clinical conditions among high-cost older adults health care users. Multinomial logistic regression models were also used to determine the associations between demographic characteristics, insurance types, and patterns of clinical conditions. Five clinically distinctive subgroups of high-cost older adults emerged. Classes included "cerebrovascular diseases" (10.6% of high-cost older adults), "malignant tumor" (9.1%), "arthrosis" (8.8%), "ischemic heart disease" (7.4%), and "other sporadic diseases" (64.1%). Age, sex, and type of medical insurance were predictors of high-cost older adult subgroups. Profiling patterns of clinical conditions among high-cost older adults is potentially useful as a first step to inform the development of tailored management and intervention strategies.