Featured Research

from universities, journals, and other organizations

Medicare costs in last six months of life driven by patient variables twice as much as geography

Date:
February 14, 2011
Source:
The Mount Sinai Hospital / Mount Sinai School of Medicine
Summary:
A new study finds that Medicare costs at the end of life are influenced more by patient characteristics, such as ability to function, the severity of the illness, and family support than by regional factors, such as the number of hospital beds available.

A study by Mount Sinai School of Medicine finds that Medicare costs at the end of life are influenced more by patient characteristics, such as ability to function, the severity of the illness, and family support than by regional factors, such as the number of hospital beds available. The study will be published February 15 in The Annals of Internal Medicine.

"These new findings show that the reasons for wide variation in Medicare costs across the United States are much more complicated than previously thought," said lead author Amy Kelley, MD, Assistant Professor in the Department of Geriatrics and Palliative Medicine at Mount Sinai School of Medicine. "The health care system should address the specific needs of patients, rather than focusing solely on the difference we see across regions. That means we need to extend care beyond the standard single disease-oriented models of care," added Dr. Kelley.

Prior studies had shown dramatic geographic variation in Medicare costs among people with chronic illnesses, especially near the end of life. However, they did not take into account individual patient characteristics, such as a person's ability to walk and take care of themselves, day-to-day.

For this new study, researchers from Mount Sinai and the University of California, Los Angeles (UCLA) examined 2,400 older adults from across the United States, as well as characteristics of their local health care system, to explore which factors were related to Medicare expenses in their last six months of life. Impairment or decline in a person's function, or the ability to take care of him or herself, was a strong predictor of higher Medicare costs ─ even more so than their medical conditions.

Regional factors, such as having more hospital beds or a pattern of high-intensity practice also predicted higher Medicare expenses. But overall, this study determined that patient characteristics explained ten percent of the Medicare cost variation, double the cost variation attributed to regional factors -- five percent.

"This raises additional questions that future research will need to address, such as why it is that having family nearby is associated with lower Medicare costs," said Catherine Sarkisian, MD, Associate Professor in the Division of Geriatrics at UCLA and senior author on the study. "Having a caregiver available may help people avoid undesired hospital stays. If so, future research must look at the impact on families that take on the expense and burden of care giving."

According to Dr. Kelley, the study's findings suggest that, "Health care reform will have the greatest impact on reducing costs if we focus on providing well-coordinated, high-quality care for the most complicated patients and their family caregivers."


Story Source:

The above story is based on materials provided by The Mount Sinai Hospital / Mount Sinai School of Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Amy S. Kelley, Susan L. Ettner, R. Sean Morrison, Qingling Du, Neil S. Wenger, and Catherine A. Sarkisian. Determinants of Medical Expenditures in the Last 6 Months of Life. Ann Intern Med, February 15, 2011 154:235-242 [link]

Cite This Page:

The Mount Sinai Hospital / Mount Sinai School of Medicine. "Medicare costs in last six months of life driven by patient variables twice as much as geography." ScienceDaily. ScienceDaily, 14 February 2011. <www.sciencedaily.com/releases/2011/02/110214201838.htm>.
The Mount Sinai Hospital / Mount Sinai School of Medicine. (2011, February 14). Medicare costs in last six months of life driven by patient variables twice as much as geography. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2011/02/110214201838.htm
The Mount Sinai Hospital / Mount Sinai School of Medicine. "Medicare costs in last six months of life driven by patient variables twice as much as geography." ScienceDaily. www.sciencedaily.com/releases/2011/02/110214201838.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Nigeria Ups Ebola Stakes on 1st Death

Nigeria Ups Ebola Stakes on 1st Death

Reuters - Business Video Online (July 29, 2014) Nigerian authorities have shut and quarantined a Lagos hospital where a Liberian man died of the Ebola virus, the first recorded case of the highly-infectious disease in Africa's most populous economy. David Pollard reports Video provided by Reuters
Powered by NewsLook.com
Running 5 Minutes A Day Might Add Years To Your Life

Running 5 Minutes A Day Might Add Years To Your Life

Newsy (July 29, 2014) According to a new study, just five minutes of running or jogging a day could add years to your life. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Poses Little Threat To U.S.: CDC

Ebola Outbreak Poses Little Threat To U.S.: CDC

Newsy (July 29, 2014) The Ebola outbreak in West Africa poses little threat to Americans, according to officials with the Centers for Disease Control and Prevention. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins