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Over the past 5 years, HCUs (i.e., top 5% of the population) utilized ~50% of the annual health expenditure, confirming that even during the pandemic year of 2020, the HCU phenomenon still existed.

The characteristics of HCU patients remained relatively the same from 2016 to 2020, in terms of proportion of male to female patients (~55% versus ~45%), age (55 to 57 years old), length of stay (~7 days), number of admissions (~7 visits), and the average healthcare cost per patient (≥THB 100,000).

In addition, the top 5 primary diagnoses for HCUs did not change over time.

Understanding the trends of healthcare utilization and expenditure, along with potential predictors for HCUs, policies can be introduced to ensure appropriate allocation of health resources to the right people in need with the right care during future pandemics.