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

2009 ◽  
Vol 89 (4) ◽  
pp. 324-332 ◽  
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.

Life Themes: A Method to Understand Terminal Illness

1995 ◽  
Vol 31 (3) ◽  
pp. 189-206 ◽  
Author(s):  
Debbie Messer Zlatin
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Terminal Illness ◽  
Terminally Ill ◽  
Care Providers ◽  
Incurable Cancer ◽  
Doctor Patient Communication ◽  
The Patient’S View ◽  
Care Costs

As health care costs in general soar, the high cost of terminal care is questioned. Yet little is known about what kinds of medical care terminally ill persons, themselves, want. To explore the patient's view, I conducted a qualitative study of eight patients with incurable cancer to answer the question, “How do terminally ill persons understand their illnesses and treatments?” Analysis of interview transcripts indicated that study participants created illness-understandings within the context of their daily life experiences via life themes. Since life themes integrate and give meaning to illness events in both emic and etic ways and help to explain patients' coping strategies, it is recommended that health care providers elicit patients' life themes and use them in their approaches to diagnosis and treatment. The possible benefits of the life theme method are more balanced doctor/patient communication, improved patient satisfaction and quality of life, and the containment of health care costs.

User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do With It?)

1995 ◽  
Vol 14 (2) ◽  
pp. 360-390 ◽  
Author(s):  
Robert G. Evans ◽  
Morris L. Barer ◽  
Greg L. Stoddart
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Final Analysis ◽  
User Fees ◽  
Care Providers ◽  
Positive Effects ◽  
The Face ◽  
Care Costs

ABSTRACTCalls for user fees in Canadian health care go back as far as the debate leading up to the establishment of Canada's national hospital insurance program in the late 1950s. Although the rationales have shifted around somewhat, some of the more consistent claims have been that user fees are necessary as a source of additional revenue for a badly underfunded system, that they are necessary to control runaway health care costs, and that they will deter unnecessary use (read abuse) of the system. But the real reasons that user fees have been such hardy survivors of the health policy wars, bear little relation to the claims commonly made for them. Their introduction in the financing of hospital or medical care in Canada would be to the benefit of a number of groups, and not just those one usually thinks of. We show that those who are healthy, and wealthy, would join health care providers (and possibly insurers) as net beneficiaries of a reintroduction of user fees for hospital and medical care in Canada. The flip side of this is that those who are indigent and ill will bear the brunt of the redistribution (for that is really what user fees are all about), and seniors feature prominently in those latter groups. Claims of other positive effects of user fees, such as reducing total health care costs, or improving appropriateness or accessibility, simply do not stand up in the face of the available evidence. In the final analysis, therefore, whether one is for or against user fees reduces to whether one is for or against the resulting income redistribution.

Acute Health Care Costs for the Aged Medicare Population: Overview and Policy Options

1987 ◽  
Vol 65 (3) ◽  
pp. 397 ◽  
Author(s):  
Sandra Christensen ◽  
Stephen H. Long ◽  
Jack Rodgers
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Policy Options ◽  
Medicare Population ◽  
Acute Health Care ◽  
Care Costs

Disability and health care costs in the Medicare population

2002 ◽  
Vol 83 (9) ◽  
pp. 1196-1201 ◽  
Author(s):  
Leighton Chan ◽  
Shelli Beaver ◽  
Richard F. MacLehose ◽  
Amitabh Jha ◽  
Matthew Maciejewski ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Disability And Health ◽  
Medicare Population ◽  
Care Costs

Avalanche or Glacier?: Health Care and the Demographic Rhetoric

1995 ◽  
Vol 14 (2) ◽  
pp. 193-224 ◽  
Author(s):  
Morris L. Barer ◽  
Robert G. Evans ◽  
Clyde Hertzman
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Costs ◽  
Common Finding ◽  
Care Providers ◽  
Term Care ◽  
The Past ◽  
Effects Of Aging ◽  
Care Costs ◽  
Care System

ABSTRACTClaims that the health care system is about to be engulfed in a “wave of grey” have become commonplace. Recent cost escalation is commonly attributed to the aging of the population, and there is no shortage of dire warnings about the cost implications of the even more dramatic aging, and costs, still to come. These claims have been largely unsubstantiated. Yet they persist for a number of reasons. First, over long periods of time, the effects of demographic trends can be (and probably will be) quite substantial. But these effects move like glaciers, not avalanches. Second, the effects of aging populations on some types of services which cater differentially to seniors will be much more dramatic; observers of those sub-sectors (such as long-term care) tend to extrapolate that sector-specific experience to health care generally. Third, at the “coal-face,” health care providers are seeing their practices become ever more dominated by seniors. They mistake this increased “presence” of patients aged 65 and over in their practices as evidence of the effects of demographic changes. In this paper we discuss each of these sources of error about the effects of aging population on health care costs. We focus primarily on the confusion between changes in patterns of care for particular age groups, and changes in overall levels of care. Quite extensive empirical evidence has been collected over the past decade from analyses of British Columbia data bases, and these findings are not unique, in Canada, or beyond. The common finding of this body of research is that population aging has accounted for very little of the increase in health care costs over the past three decades, in Canada or elsewhere. Health care utilization has increased dramatically among seniors. But this has had less to do with the fact that there are more of them, than with the fact that the health care system is doing much more to (and for) them than was the case even a decade ago. This suggests that the appropriate care of elderly people should be a central issue for health care policy and management, but that demographic issues are, in the short run at least, largely a red herring.

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

2020 ◽  
Author(s):  
Nabila Dahodwala ◽  
Pengxiang Li ◽  
Jordan Jahnke ◽  
Vrushabh P. Ladage ◽  
Amy R. Pettit ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Health Care ◽  
Parkinson's Disease ◽  
Health Care Costs ◽  
Medicare Population ◽  
Care Costs ◽  
The U.S

Freestanding Emergency Centers: Regulation and Reimbursement

1985 ◽  
Vol 11 (1) ◽  
pp. 105-129
Author(s):  
Mitchell Katzman
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Health Care Market ◽  
Care Providers ◽  
Emergency Rooms ◽  
Hospital Emergency ◽  
Efficient Manner ◽  
Additional Layer ◽  
Care Costs

AbstractThe freestanding emergency center, which combines the functions of a doctor's office and a hospital emergency room, has emerged as a new provider of health care. These centers have generated considerable controversy over their role in the health care market. Proponents argue that freestanding emergency centers reduce costs by providing care in a more efficient manner and cause other health care providers such as hospital emergency rooms to reduce costs and improve service. Opponents argue that the centers create an additional layer of health care which duplicates existing services and increases total health care costs. This Note examines the controversial issues of licensure, regulation and reimbursement. The Note concludes that freestanding emergency centers can help to reduce health care costs and discusses the steps that should be taken to aid centers in achieving this goal.

scholarly journals Reducing Health Care Costs and Improving Clinical Outcomes Using an Improved Asheville Project Model

2015 ◽  
Vol 6 (4) ◽  
Author(s):  
Barry A. Bunting ◽  
Deepika Nayyar ◽  
Christine Lee
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Electronic Record ◽  
The Body ◽  
Control Group ◽  
Original Research ◽  
Group Model ◽  
Care Providers ◽  
Project Model ◽  
Care Costs

This study was designed to add to the body of knowledge gained through the original Asheville Project studies, and to address some of the limitations of the earlier studies. Scalability. Since the original Asheville Project publications there have been some successful replications, however, there is a need to broaden the geographic scope and increase the size of the study population. Study Design. Previous studies were limited to pre-post, self-as-control design. We added a control group. Model improvement. We were able to incorporate an electronic record of care. This allows incorporation of medical and prescription claims, ease of documentation, improved data capture, reporting, standardization of care, identification of deficiencies in care, and communication with other health care providers. This enhancement may be worthy of more comment than we devoted to it , however, we didn’t want to detract from the main goal of the study, and we wanted to avoid any hint of commercialization on the part of the organization that provided the electronic record. Relevance to profession. We sincerely hope the relevance goes beyond the profession of pharmacy and that it reinforces the message that the profession of pharmacy offers real solutions to rising health care costs in the U.S.   Type: Original Research

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