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Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults.

Publication ,  Journal Article
Deardorff, WJ; Liu, PL; Sloane, R; Van Houtven, C; Pieper, CF; Hastings, SN; Cohen, HJ; Whitson, HE
Published in: J Am Geriatr Soc
August 2019

OBJECTIVES: To examine the association between self-reported vision impairment (VI), hearing impairment (HI), and dual-sensory impairment (DSI), stratified by dementia status, on hospital admissions, hospice use, and healthcare costs. DESIGN: Retrospective analysis. SETTING: Medicare Current Beneficiary Survey from 1999 to 2006. PARTICIPANTS: Rotating panel of community-dwelling Medicare beneficiaries, aged 65 years and older (N = 24 009). MEASUREMENTS: VI and HI were ascertained by self-report. Dementia status was determined by self-report or diagnosis codes in claims data. Primary outcomes included any inpatient admission over a 2-year period, hospice use over a 2-year period, annual Medicare fee-for-service costs, and total healthcare costs (which included information from Medicare claims data and other self-reported payments). RESULTS: Self-reported DSI was present in 30.2% (n = 263/871) of participants with dementia and 17.8% (n = 4112/23 138) of participants without dementia. In multivariable logistic regression models, HI, VI, or DSI was generally associated with increased odds of hospitalization and hospice use regardless of dementia status. In a generalized linear model adjusted for demographics, annual total healthcare costs were greater for those with DSI and dementia compared to those with DSI without dementia ($28 875 vs $3340, respectively). Presence of any sensory impairment was generally associated with higher healthcare costs. In a model adjusted for demographics, Medicaid status, and chronic medical conditions, DSI compared with no sensory impairment was associated with a small, but statistically significant, difference in total healthcare spending in those without dementia ($1151 vs $1056; P < .001) but not in those with dementia ($11 303 vs $10 466; P = .395). CONCLUSION: Older adults with sensory and cognitive impairments constitute a particularly prevalent and vulnerable population who are at increased risk of hospitalization and contribute to higher healthcare spending. J Am Geriatr Soc 67:1617-1624, 2019.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

August 2019

Volume

67

Issue

8

Start / End Page

1617 / 1624

Location

United States

Related Subject Headings

  • Vision Disorders
  • United States
  • Sensation Disorders
  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Medicare
  • Male
  • Logistic Models
  • Independent Living
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Deardorff, W. J., Liu, P. L., Sloane, R., Van Houtven, C., Pieper, C. F., Hastings, S. N., … Whitson, H. E. (2019). Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults. J Am Geriatr Soc, 67(8), 1617–1624. https://doi.org/10.1111/jgs.15891
Deardorff, William James, Phillip L. Liu, Richard Sloane, Courtney Van Houtven, Carl F. Pieper, Susan Nicole Hastings, Harvey J. Cohen, and Heather E. Whitson. “Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults.J Am Geriatr Soc 67, no. 8 (August 2019): 1617–24. https://doi.org/10.1111/jgs.15891.
Deardorff WJ, Liu PL, Sloane R, Van Houtven C, Pieper CF, Hastings SN, et al. Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults. J Am Geriatr Soc. 2019 Aug;67(8):1617–24.
Deardorff, William James, et al. “Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults.J Am Geriatr Soc, vol. 67, no. 8, Aug. 2019, pp. 1617–24. Pubmed, doi:10.1111/jgs.15891.
Deardorff WJ, Liu PL, Sloane R, Van Houtven C, Pieper CF, Hastings SN, Cohen HJ, Whitson HE. Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults. J Am Geriatr Soc. 2019 Aug;67(8):1617–1624.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

August 2019

Volume

67

Issue

8

Start / End Page

1617 / 1624

Location

United States

Related Subject Headings

  • Vision Disorders
  • United States
  • Sensation Disorders
  • Retrospective Studies
  • Patient Acceptance of Health Care
  • Medicare
  • Male
  • Logistic Models
  • Independent Living
  • Humans