"Functional status is extremely important for geriatric patients. The population is aging and a lot of people have functional disabilities, yet no one had done a study taking into account how functional impairments in older patients affect hospital costs," says the study's lead author, Kenneth Chuang, MD, a Veterans Affairs National Quality Scholar at SFVAMC. "While most people understand that Medicare patients who are sicker or less functionally independent are going to end up costing more, they probably don't realize that hospitals usually don't get paid more for their care." The study appears in the December Journal of the American Geriatrics Society.
Researchers need to conduct such studies at other hospitals, Chuang says. If the findings are similar, he says, it would mean that under the current Medicare payment system there is an economic incentive for hospitals to discourage admission of dependent older patients, or to quickly discharge them. "If these findings hold true at other institutions," Chuang says, "it will be important for Medicare to address these financial inequities."
Chuang and his team based their analysis on a study conducted at the University Hospitals of Cleveland between 1993 and 1997. In this earlier study, investigators evaluated whether interventions such as physical therapy could decrease the length of stay and improve outcomes for older inpatients. They also tracked costs for each patient using the hospital's cost management information system, a
Contact: Liese Greensfelder
University of California - San Francisco