Table 3.
Unadjusted and Adjusted Medicare Expenditures for Hospitalizations and ED Visits in the Last Year of Life Among FFS Medicare Beneficiaries in the HRS Who Died, 2000-2008.
| Dementia |
No dementia |
Difference | |
|---|---|---|---|
| Mean (SD) | Mean (SD) | ||
| Unadjusted | |||
| Community decedents | |||
| Hospitalizations, total | $20 321 ($33 842) | $23 953 ($34 049) | −$3631** |
| Hospitalizations, potentially avoidable | $5788 ($16 260) | $5 250 ($13 032) | $538 |
| Outpatient ED visits, total | $330 ($583) | $295 ($560) | $34 |
| Outpatient ED visits, potentially avoidable | $79 ($314) | $59 ($229) | $20 |
| Nursing home decedents | |||
| Hospitalizations, total | $13 534 ($20 819) | $23 907 ($40 352) | −$10 373* |
| Hospitalizations, potentially avoidable | $5253 ($10 682) | $9507 ($23 151) | −$4254 |
| Outpatient ED visits, total | $253 ($547) | $331 ($625) | −$78 |
| Outpatient ED visits, potentially avoidable | $52 ($186) | $41 ($129) | $11 |
| Mean (SD) | Mean (SD) | Differencea | |
| Adjusted | |||
| Community decedents | |||
| Hospitalizations, total | $19 817 ($6310) | $23 138 ($7364) | −$3320*** |
| Hospitalizations, potentially avoidable | $5442 ($2315) | $5808 ($2493) | −$366** |
| Outpatient ED visits, total | $327 ($142) | $285 ($133) | $42*** |
| Outpatient ED visits, potentially avoidable | $76 ($62) | $68 ($57) | $9** |
| Nursing home decedents | |||
| Hospitalizations, total | $13 688 ($9398) | $22 496 ($14 237) | −$8808*** |
| Hospitalizations, potentially avoidable | $5369 ($4009) | $7866 ($5943) | −$2497*** |
| Outpatient ED visits, total | $261 ($193) | $300 ($218) | −$39** |
| Outpatient ED visits, potentially avoidable | $59 ($85) | $22 ($32) | $37*** |
Source. Authors’ analysis of HRS data linked with Medicare claims, 2000-2008.
Note. The adjusted expenditures reported are in constant 2008 dollars, estimated from multivariate 2-part models controlling for dementia, age, gender, race/ethnicity, education, marital status, types of health insurance coverage, activities of daily living limitations, chronic conditions (total count and specific conditions), self-rated health status, income, urban location, census region, and year of death. The unweighted number of observations was 918 and 1712 for community decedents with and without dementia, respectively, and 545 and 70 for nursing home decedents with and without dementia, respectively. ED = emergency department; HRS = Health and Retirement Study; FFS = fee-for-service.
Estimated net amount of expenditures that is attributable to dementia, independent of the effects of all other risk factors included in the models.
P < .05. **P < .01. ***P < .001.