Table 6. Average Medicare Expenses and Predictive Ratios, by Institutional and Functional Status and Type of Service: Pooled Data, 1991-1994.
Institutional and Functional Status | Total Expenses | Inpatient Hospital | Outpatient Hospital | Physician | Skilled Nursing Facility | Home Health | ||||||
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Actual | Predictive Ratio | Actual | Predictive Ratio | Actual | Predictive Ratio | Actual | Predictive Ratio | Actual | Predictive Ratio | Actual | Predictive Ratio | |
Total | $5,186 | 1.00 | $2,805 | 1.00 | $388 | 1.00 | $1,417 | 1.00 | $175 | 1.00 | $401 | 1.00 |
Non-Institutionalized | 5,153 | 0.97 | 2,805 | 0.97 | 372 | 1.01 | 1,397 | 0.99 | 162 | 1.03 | 418 | 0.90 |
0 ADL | 3,604 | 1.18 | 1,976 | 1.16 | 314 | 1.05 | 1,125 | 1.08 | 72 | 1.89 | 116 | 2.45 |
1-2 ADLs | 6,763 | 0.87 | 3,815 | 0.84 | 435 | 0.98 | 1,743 | 0.90 | 258 | 0.78 | 511 | 0.95 |
3-4 ADLs | 9,131 | 0.76 | 4,928 | 0.77 | 557 | 0.88 | 2,038 | 0.88 | 332 | 0.74 | 1,276 | 0.48 |
5-6 ADLs | 13,557 | 0.64 | 6,543 | 0.73 | 592 | 1.00 | 2,643 | 0.82 | 731 | 0.44 | 3,047 | 0.27 |
Institutionalized | 5,960 | 1.57 | 2,827 | 1.79 | 760 | 0.88 | 1,877 | 1.24 | 494 | 0.75 | 2 | 482.00 |
R-square | 0.07 | 0.04 | 0.04 | 0.11 | 0.01 | 0.04 |
NOTES: ADL is activity of daily living. ADL status was measured in the base years. A predictive ratio is the ratio of predicted to actual average Medicare expenses, excluding hospice expenses. Predicted values are based on hierarchial coexisting conditions. Analysis is based on 32,228 Medicare cases (unweighted).
SOURCE: Medicare Current Beneficiary Survey, 1991-1994.