Life-space mobility and healthcare costs and utilization in older men.
J Am Geriatr Soc
; 69(8): 2262-2272, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-33961699
ABSTRACT
OBJECTIVES:
To determine the association of life-space score with subsequent healthcare costs and utilization.DESIGN:
Prospective cohort study (Osteoporotic Fracture in Men [MrOS]).SETTING:
Six U.S. sites.PARTICIPANTS:
A total of 1555 community-dwelling men (mean age 79.3 years; 91.5% white, non-Hispanic) participating in the MrOS Year 7 (Y7) examination linked with their Medicare claims data. MEASUREMENTS Life-space during the past month was assessed as 0 (daily restriction to one's bedroom) to 120 (daily trips outside one's town without assistance) and categorized (0-40, 41-60, 61-80, 81-100, 101-120). Total annualized direct healthcare costs and utilization were ascertained during 36 months after the Y7 examination.RESULTS:
Mean total annualized costs (2020 U.S. dollars) steadily increased across category of life-space score, from $7954 (standard deviation [SD] 16,576) among men with life-space scores of 101-120 to $26,430 (SD 28,433) among men with life-space scores of 0-40 (p < 0.001). After adjustment for demographics, men with a life-space score of 0-40 versus men with a life-space score of 101-120 had greater mean total costs (cost ratio [CR] = 2.52; 95% confidence interval [CI] = 1.84-3.45) and greater risk of subsequent hospitalization (odds ratio [OR] 4.72, 95% CI 2.61-8.53) and skilled nursing facility (SNF) stay (OR 7.32, 95% CI 3.65-14.66). Life-space score was no longer significantly associated with total healthcare costs (CR for 0-40 vs 101-120 1.29; 95% CI 0.91-1.84) and hospitalization (OR 1.76, 95% CI 0.89-3.51) after simultaneous consideration of demographics, medical factors, self-reported health and function, and the frailty phenotype; the association of life-space with SNF stay remained significant (OR 2.86, 95% CI 1.26-6.49).CONCLUSION:
Our results highlight the importance of function and mobility in predicting future healthcare costs and suggest the simple and convenient life-space score may in part capture risks from major geriatric domains and improve identification of older, community-dwelling men likely to require costly care.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
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Custos de Cuidados de Saúde
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Limitação da Mobilidade
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Vida Independente
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Fragilidade
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Hospitalização
Tipo de estudo:
Etiology_studies
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Health_economic_evaluation
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Humans
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Male
Idioma:
En
Revista:
J Am Geriatr Soc
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos