HealthDay News — According to a study published in the Journal of the American Geriatrics Society, pre-admission functional impairment is associated with greater Medicare costs for post-acute care for community-dwelling older adults.

S Ryan Greysen, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a longitudinal cohort study involving a nationally representative sample of 16,673 Medicare hospitalizations of 8559 community-dwelling older adults from 2000 to 2012. The authors examined total Medicare costs in the year after hospital discharge.

The researchers found that the unadjusted mean Medicare costs for one year after discharge increased with the severity of pre-admission impairment in a dose-response fashion (P<.001 for trend); 68, 17, 7, and 8% had no functional impairment, difficulty with one activity of daily living (ADL), dependency in one ADL, and dependency in two or more ADLs, respectively. 

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Compared to those without impairment, the most severely impaired participants cost 77% more; attenuated effect size was seen in adjusted analyses, but there was no change in trend. Only 3 conditions (lymphoma, metastatic cancer, and paralysis) were more expensive than severe functional impairment.

“Functional impairment is associated with greater Medicare costs for post-acute care and may be an unmeasured but important marker of long-term costs that cuts across conditions,” the authors write.


Greysen SR, et al. “Functional Impairment: An Unmeasured Marker Of Medicare Costs For Postacute Care Of Older Adults”. Journal of the American Geriatrics Society. 2017. doi: 10.1111/jgs.14955 [Epub ahead of print]

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