Mar 27, 2003

Comorbidity and the concentration of healthcare expenditures in older patients with heart failure

Journal of the American Geriatrics Society
James X ZhangMarshall H Chin

Abstract

To examine comorbidity and concentration of healthcare expenditures in older patients with heart failure (HF) in the Medicare program. Retrospective analysis of older fee-for-service HF patients, using the 1996 Medicare Current Beneficiary Survey and linked Medicare claims. Variety of clinical settings. One thousand two hundred sixty-six older HF patients from a nationally representative survey. Medicare expenditure per person and by types of healthcare services, prevalence of comorbid conditions, and multivariate regression on the association between comorbidities and healthcare expenditure. Medicare spent an average of 16,514 dollars on medical reimbursement for each HF patient in 1996. Eighty-one percent of patients had one or more comorbid diseases according to a 17-disease grouping index. The top 20% of HF patients accounted for 63% of total expenditure. Comorbidity was associated with significantly higher Medicare expenditure. HF patients with more-expensive comorbidities included those with peripheral vascular disease (24% of patients, mean total expenditure 26,954 dollars), myocardial infarction (16% of patients, mean total expenditure 29,867 dollars), renal disease (8% of patients, mean total expenditure 33,014 dollars...Continue Reading

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Mentioned in this Paper

Gerontology
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Myocardial Infarction
A 17
Expenditures, Indirect
Insurance, Health, for Aged and Disabled
Regression Analysis
Comorbidity
Self Care (Rehabilitation)
Peripheral Vascular Diseases

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