Abstract:
OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N = 2,510). MEASUREMENTS:Medicare costs were calculated for 2, 7, 14, 30, 90, and 180 days before death; Medicaid costs were calculated for dual-eligible beneficiaries. Total costs and costs for hospice, NH, and inpatient care are reported. RESULTS:Of 2,510 long-stay NH decedents, 35% received hospice. Mean length of hospice was 103 days (median 34 days). Hospice users were more likely to have cancer (P < .001), a do-not-resuscitate order in place (P < .001), greater cognitive impairment (P < .001), and worse activity of daily living (ADL) function (P < .001) and less likely to have had a hospitalization in the year before death (P < .001). In propensity score analyses, hospice users had lower total Medicare costs for all time periods up to and including 90 days before death. For dually eligible beneficiaries, overall costs and Medicare costs were significantly lower for hospice users up to 30 days before death. Medicaid costs were not different between the groups except for the 2-day time period. CONCLUSION:In this analysis of costs to Medicare and Medicaid for long-stay NH decedents, use of hospice did not increase costs in the last 6 months of life. Evidence supporting cost savings is sensitive to analyses that vary the time period before death.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Unroe KT,Sachs GA,Dennis ME,Hickman SE,Stump TE,Tu W,Callahan CMdoi
10.1111/jgs.14070subject
Has Abstractpub_date
2016-04-01 00:00:00pages
723-30issue
4eissn
0002-8614issn
1532-5415journal_volume
64pub_type
杂志文章abstract:OBJECTIVES:To compare the efficacy and safety of ertapenem, 1 g once a day, with ceftriaxone, 1 g once a day, for treatment of the subgroup of patients aged 65 and older with community-acquired pneumonia (CAP) requiring parenteral therapy. DESIGN:Combined data from patients aged 65 and older in two randomized, double-...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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abstract:OBJECTIVES:The specific goals of the study were to compare three health status measures among older adults for their correlations with similar scales and to examine whether extreme (positive) health states might lead to measurement problems. We also report on practical administration and response problems among older a...
journal_title:Journal of the American Geriatrics Society
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更新日期:2001-06-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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更新日期:2004-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00515.x
更新日期:1980-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1985.tb02856.x
更新日期:1985-01-01 00:00:00
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更新日期:2014-10-01 00:00:00
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2017-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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更新日期:1994-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1999.tb07237.x
更新日期:1999-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16638
更新日期:2020-10-01 00:00:00