Journal article
The Effect of Self-Reported and Performance-Based Functional Impairment on Future Hospital Costs of Community-Dwelling Older Persons
The Gerontologist, Vol.44(3), pp.401-407
06/2004
DOI: 10.1093/geront/44.3.401
PMID: 15197294
Abstract
Purpose: We determined the prognostic value of self-reported and performance-based measurement of function, including functional transitions and combining different measurement approaches, on utilization. Design and Methods: Our cohort study used the 6th, 7th, and 10th waves of three sites of the Established Populations for Epidemiologic Studies of the Elderly, linked to 1- and 4-year Medicare Part A hospital costs. We examined mean hospital expenditures based on (a) 1- and 4-year transitions in self-reported functional status; (b) 4-year transitions in performance-based functional status; (c) combined baseline self-reported and performance-based functional status; and (d) poorest self-reported and performance-based functional status during a 4-year period. Results: Even modest declines in self-reported or performance-based functional status were associated with increased expenditures. When baseline self-reported and performance-based assessments were combined, mean 1- and 4-year adjusted costs were higher with progressively worse performance-based scores, even among those who were independent in self-reported function. When the poorest 4-year self-reported and performance-based functions were examined, self-reported functioning was the most important determinant of hospital costs, but within each self-reported functional level, poorer performance-based function was associated with progressively higher costs. Implications: The costs associated with even modest functional decline are high. Combining self-reported and performance-based measurements can provide more precise estimates of future hospital costs.
Details
- Title: Subtitle
- The Effect of Self-Reported and Performance-Based Functional Impairment on Future Hospital Costs of Community-Dwelling Older Persons
- Creators
- David B. Reuben - University of California, Los AngelesTeresa E. SeemanEmmett KeelerRisa P. HayesLee BowmanAse SewallSusan H. HirschRobert B. WallaceJack M. Guralnik
- Resource Type
- Journal article
- Publication Details
- The Gerontologist, Vol.44(3), pp.401-407
- DOI
- 10.1093/geront/44.3.401
- PMID
- 15197294
- NLM abbreviation
- Gerontologist
- ISSN
- 0016-9013
- eISSN
- 1758-5341
- Publisher
- Oxford University Press
- Language
- English
- Date published
- 06/2004
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984364412202771
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