| Comorbid Diabetes and End-of-Life Expenditures Among Medicare Beneficiaries With Heart Failure. | |
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MedLine Citation:
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PMID: 22196840 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Diabetes is associated with increased risk of mortality in heart failure. We examined the association of diabetes with expenditures, hospitalizations, and procedures among Medicare beneficiaries with heart failure during the last 6 months of life. METHODS AND RESULTS: In a 5% national Medicare sample, the prevalence of diabetes was 41.7% among 16,613 beneficiaries who died in 2007 with a diagnosis of heart failure. Diabetes was associated with higher expenditures during the last 6 months of life (mean $39,042 vs $29,003; P < .001), even after adjusting for covariates, including age, sex, race, geographic location, comorbidities, and preceding hospitalizations (cost ratio 1.08, 95% CI 1.05-1.12). For both diabetic and nondiabetic adults, more than one-half of Medicare expenditures were related to hospitalization costs (mean $22,516 vs $15,721; P < .001). Compared with their counterparts without diabetes, beneficiaries with diabetes had higher rates of hospitalization (adjusted incidence rate ratio 1.09, 95% CI 1.05-1.12) and days spent in the intensive care unit. CONCLUSIONS: Comorbid diabetes was common in heart failure and associated with higher expenditures, much of which was driven by increased rates of hospitalizations. Programs that focus on prevention of hospitalizations may reduce the substantial costs associated with heart failure near the end of life. |
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Authors:
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Saul Blecker; Robert Herbert; Frederick L Brancati |
Publication Detail:
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Type: Journal Article Date: 2011-11-09 |
Journal Detail:
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Title: Journal of cardiac failure Volume: 18 ISSN: 1532-8414 ISO Abbreviation: J. Card. Fail. Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2011-12-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 41-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of General Internal Medicine, New York University School of Medicine, New York, New York; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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