Table 2.
Health Care Utilization by Elderly Medicare Beneficiaries in the Four Subgroups.
| Health-related outcomes | Coexisting dementia and cancer (n = 1,294), n (%) | Dementia only (n = 8,533), n (%) | Cancer only (n = 11,696), n (%) | Neither dementia nor cancer (n = 74,601), n (%) |
|---|---|---|---|---|
| Rate of hospitalizations* | 397 (30.68) | 2,220 (25.96) | 2,249 (19.23) | 7,566 (10.11) |
| Percent with 3 or more hospitalizations* | 257 (19.86) | 1,017 (11.92) | 612 (5.23) | 1,208 (1.62) |
| Number of hospitalizations, M (SD) | 1.47 (1.53) | 0.99 (1.37) | 0.54 (1.02) | 0.22 (0.65) |
| Among those hospitalized | ||||
| Average length of stay (days) for hospitalizations, M (SD) | 7.41 (6.61) | 7.00 (8.00) | 6.31 (6.38) | 5.41 (7.57) |
| Number of hospital readmissions within 30 days, M (SD) | 0.50 (0.91) | 0.40 (0.84) | 0.29 (0.70) | 0.18 (0.56) |
| Rate of hospital readmissions within 30 days* | 211 (23.47) | 820 (18.91) | 602 (16.13) | 1,078 (9.84) |
| Percent with 2 or more hospital readmissions within 30 days* | 102 (11.35) | 387 (8.92) | 230 (6.16) | 346 (3.16) |
| Average length of stay (days) for hospital readmissions within 30 days, M (SD) | 8.23 (8.40) | 7.60 (6.94) | 7.70 (6.87) | 6.26 (5.63) |
| Number of intensive care unit use, M (SD) | 0.52 (0.76) | 0.47 (0.76) | 0.45 (0.73) | 0.40 (0.68) |
| Rate of intensive care unit use* | 350 (38.93) | 1,535 (35.39) | 1,327 (35.55) | 3,597 (32.82) |
| Percent with ≥3 intensive care use* | 23 (1.78) | 91 (1.07) | 74 (0.63) | 154 (0.21) |
| Number of ED visits, M (SD) | 2.54 (2.56) | 2.22 (1.74) | 1.75 (1.31) | 1.56 (1.18) |
| Rate of ED visits* | 962 (74.34) | 5,283 (61.91) | 3,951 (33.78) | 16,274 (21.28) |
| Percent with ≥3 ED visits* | 348 (36.17) | 1,565 (29.62) | 692 (17.51) | 2,028 (12.46) |
| Number of physician care visits, M (SD) | 5.75 (6.42) | 5.20 (5.76) | 3.47 (3.65) | 2.66 (3.23) |
| Percentage with ≥6 physician care visits* | 483 (37.33) | 2,954 (34.62) | 2,379 (20.34) | 10,515 (14.09) |
| Number of days in nursing homes, M (SD) | 50.77 (46.37) | 58.21 (57.91) | 35.77 (37.55) | 40.73 (43.58) |
| Hospice stay* | 267 (20.63) | 1,007 (11.80) | 644 (5.51) | 658 (0.88) |
| Number of days in hospice, M (SD) | 31.56 (59.49) | 39.67 (75.47) | 25.47 (46.06) | 38.83 (80.42) |
| Psychiatric outpatient visit | 0.95 (3.71) | 1.22 (5.74) | 0.16 (1.69) | 0.14 (0.71) |
| Neurologist visit | 0.49 (1.27) | 0.39 (1.10) | 0.16 (0.80) | 0.12 (0.70) |
| Oncologist visit | 1.01 (2.70) | 0.60 (0.69) | 1.84 (3.96) | 0.08 (0.80) |
| Discharge location* | ||||
| Community | 797 (41.66) | 3,289 (38.90) | 4,678 (73.66) | 12,555 (76.16) |
| Nursing home | 658 (34.40) | 3,039 (35.94) | 473 (7.45) | 1,410 (8.55) |
| Hospice | 113 (5.91) | 343 (4.06) | 324 (5.10) | 222 (1.35) |
| Expired | 97 (5.07) | 393 (4.65) | 337 (5.31) | 547 (3.32) |
| Other | 248 (12.96) | 1,392 (16.46) | 539 (8.49) | 1,752 (10.63) |
| Average Medicare payment (cost in US$) | ||||
| Per hospitalization, M (SD) | 9,202.20 (9,278.00) | 8,775.04 (9,674.69) | 10,286.42 (11,541.85) | 9,450.00 (72,046.19) |
| Per hospital 30-day readmissions, M (SD) | 10,310.22 (10,921.59) | 9,767.89 (9,211.75) | 11,416.96 (13,036.11) | 9,790.40 (9,563.52) |
Note. All comparisons were against those with neither cancer nor dementia. T test or chi-square test. ED = emergency department.
*
p < .05, **p < .0001.