Document Detail


Assessment of cost and health resource utilization for elderly patients with heart failure and diabetes mellitus.
MedLine Citation:
PMID:  20610226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Our aim was to examine the health resource utilization and cost of care associated with heart failure (HF) and diabetes mellitus (DM) for elderly Medicare enrollees.
METHODS AND RESULTS: A retrospective case-control design was used to identify 4 groups of elderly patients with HF and DM (n = 498), HF only (n = 1089), DM only (n = 971), and no-HF and no-DM (n = 5438) using an administrative database of a large urban academic health care system. Demographic, diagnostic, health resource utilization, and cost (reimbursement) data were obtained from the Medicare claims database for the years 2000 and 2001. Disease states were identified by ICD-9 codes. Costs and health resource utilization were compared across the groups. The mean total costs were highest for the group with HF and DM ($32,676), and second highest for the HF only group ($22,230). In multivariable models that adjusted for potentially influential covariates, the group with HF and DM had a 3-fold increase in total cost compared with the group without DM and HF (relative total cost = 4.51, 95% confidence interval 3.82-5.31).
CONCLUSIONS: The presence of DM has a substantial influence on the costs for managing older patients with HF. An integrated approach to management may be needed.
Authors:
Hillary R Bogner; Steven D Miller; Heather F de Vries; Sumedha Chhatre; Ravishankar Jayadevappa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-06
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-11-16     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  454-60     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA. hillary.bogner@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Confidence Intervals
Costs and Cost Analysis / economics
Diabetes Mellitus / economics*
Female
Health Care Costs
Health Resources / economics,  utilization*
Heart Failure / complications,  economics*
Humans
Length of Stay / statistics & numerical data
Male
Medicare / economics
Models, Statistical
Multivariate Analysis
Pennsylvania
Retrospective Studies
United States
Grant Support
ID/Acronym/Agency:
R34 MH085880-01A1/MH/NIMH NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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