Disability and health care costs in the Medicare population

摘要: Abstract Chan L, Beaver S, MacLehose RF, Jha A, Maciejewski M, Doctor JN. Disability and health care costs in the Medicare population. Arch Phys Med Rehabil 2002;83:1196-1201. Objective: To determine effect of activity limitations on expenditures. Design: Cross-sectional. Setting: National survey. Participants: Data from 1997 Current Beneficiary Survey (n=9298), a nationally representative sample community-dwelling beneficiaries who were older than 64 years age. Interventions: Not applicable. Main Outcome Measures: The impact patient disability (inpatient, outpatient, skilled nursing facility, home health, medications). Activity determined by assessment restrictions activities daily living (ADLs). Results: Over 20% (n=6,500,000) entire population had at least 1 health-related limitation. Total median per year (interquartile range [IQR]) increased as number these limitation (0 ADLs: $1934 [IQR, $801–$4761]; 1–2 $4540 $1744–$12,937]; 3–4 $7589 $2580–$23,149]; 5–6 $14,399 $5425–$33,014]). After adjusting for confounding characteristics including comorbid illnesses, enrollees incurred higher their cost ratio=1.0; ratio=1.4 [95% confidence interval (CI), 1.2–1.6]; ratio=1.6 CI, 1.3–2.0]; ratio=2.3 1.7–3.2]). increases because an increase frequency all events (eg, hospital admissions, outpatient visits) rather intensity or those events. In addition, with increasing limitations, there was significant proportional such that, 5 6 exceeded visits. Conclusions: is independent risk factor appears to be more just proxy chronic illness. © 2002 American Congress Rehabilitation Medicine Academy Physical