Burden of Parkinson's Disease by Severity: Health Care Costs in the U.S. Medicare Population

In 1899, Charles H. Duell, Commissioner of the U.S. Office of Patents, urged President McKinley to abolish the Patent Office by saying, “Everything that can be invented has been invented.” Fortunately for the health care industry, there have been more significant “medical inventions” in the 89 years following Duell's utterance than in all of recorded history preceding it.There is now a crisis in medical technology, and it has not been caused by a lack of ideas from innovative clinicians, inventors, and scientists. Instead, it is a result of sincere, but often spasmodic, efforts to control health care costs, which in the minds of many observers threaten the national economy, if not the country's survival.

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Falls in the Medicare Population: Incidence, Associated Factors, and Impact on Health Care

Physical Therapy ◽

10.2522/ptj.20070107 ◽

2009 ◽

Vol 89 (4) ◽

pp. 324-332 ◽

Cited By ~ 171

Author(s):

Anne Shumway-Cook ◽

Marcia A Ciol ◽

Jeanne Hoffman ◽

Brian J Dudgeon ◽

Kathryn Yorkston ◽

...

Keyword(s):

Health Care ◽

Activities Of Daily Living ◽

Health Care Costs ◽

Fall Prevention ◽

Daily Living ◽

Associated Factors ◽

Care Providers ◽

Medicare Population ◽

Recurrent Falls ◽

Care Costs

Background and Purpose Falls are a major health problem in the elderly community; however, questions regarding incidence, risk factors, and provider response to falls exist. The purpose of this study was to examine the incidence of falls, associated factors, health care costs, and provider response to falls among Medicare beneficiaries. Participants The participants were 12,669 respondents to the Medicare Current Beneficiaries Survey (MCBS). Methods Categories of number of falls (none, one, recurrent) and injury type (medically injurious versus not medically injurious) were created from the falls supplement to the MCBS. Means and proportions for the entire Medicare population were estimated using sampling weights. The association between sociodemographic variables and fall status was modeled using ordinal or binary logistic regression. Aggregate health costs by fall category were estimated from claims data. Results Population estimates of falls reported in 2002 ranged from 3.7 million (single fall) to 3.1 million (recurrent falls), with an estimated 2.2 million people having a medically injurious fall. Recurrent falls were more likely with increased age, being female, being nonwhite, reporting fair or poor health, and increased number of limitations in personal activities of daily living and instrumental activities of daily living and comorbidities. Although estimates of the actual costs of falls could not be determined, “fallers” consistently had larger utilization costs than “nonfallers” for the year 2002. Fewer than half (48%) of the beneficiaries reported talking to a health care provider following a fall, and 60% of those beneficiaries reported receiving fall prevention information. Discussion and Conclusions Falls are common and may be associated with significant health care costs. Most importantly, health care providers may be missing many opportunities to provide fall prevention information to older people.

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