The effect of self-reported and performance-based functional impairment on future hospital costs of community-dwelling older persons.
Gerontologist
; 44(3): 401-7, 2004 Jun.
Article
em En
| MEDLINE
| ID: mdl-15197294
ABSTRACT
PURPOSE:
We determined the prognostic value of self-reported and performance-based measurement of function, including functional transitions and combining different measurement approaches, on utilization. DESIGN ANDMETHODS:
Our cohort study used the 6th, 7th, and 10th waves of three sites of the Established Populations for Epidemiologic Studies of the Elderly, linked to 1- and 4-year Medicare Part A hospital costs. We examined mean hospital expenditures based on (a) 1- and 4-year transitions in self-reported functional status; (b) 4-year transitions in performance-based functional status; (c) combined baseline self-reported and performance-based functional status; and (d) poorest self-reported and performance-based functional status during a 4-year period.RESULTS:
Even modest declines in self-reported or performance-based functional status were associated with increased expenditures. When baseline self-reported and performance-based assessments were combined, mean 1- and 4-year adjusted costs were higher with progressively worse performance-based scores, even among those who were independent in self-reported function. When the poorest 4-year self-reported and performance-based functions were examined, self-reported functioning was the most important determinant of hospital costs, but within each self-reported functional level, poorer performance-based function was associated with progressively higher costs. IMPLICATIONS The costs associated with even modest functional decline are high. Combining self-reported and performance-based measurements can provide more precise estimates of future hospital costs.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
/
Custos Hospitalares
/
Serviços de Saúde para Idosos
/
Hospitalização
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article