Predictors of health resource use by disabled older female medicare beneficiaries living in the community

Michael Weiner, Ming Yu Fan, Brent A. Johnson, Judith D. Kasper, Gerard F. Anderson, Linda P. Fried

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVES: To identify specific clinical factors that could best predict resource use by disabled older women. DESIGN: Cross-sectional. SETTING: Urban community in Baltimore, Maryland. PARTICIPANTS: One thousand two community-dwelling, moderately to severely disabled, female Medicare beneficiaries aged 65 and older, from the Women's Health and Aging Study I (WHAS). MEASUREMENTS: WHAS data were merged with participants' 1992-1994 Medicare claims data for the year after baseline evaluation, reflecting inpatient, outpatient, home-based, and skilled-nursing services. The independent contributions of factors hypothesized to predict health expenditures were assessed, using chi-square and regression analyses, with the logarithm of Medicare expenditures as the primary outcome. RESULTS: Demographic factors were not associated with Medicare expenditures. Factors associated with expenditures in bivariate analyses included heart disease (1.4x), chronic obstructive pulmonary disease (1.3x), diabetes mellitus (1.1x), smoking, comorbidity, and severity of disability, as well as low creatinine clearance, serum albumin, caloric expenditure, or skinfold thickness. Heart disease, diabetes mellitus, and low skinfold thickness remained significant after adjustment for other factors. CONCLUSION: Heart disease, diabetes mellitus, and low skinfold thickness are important independent predictors of 1-year Medicare expenditures by disabled older women. Many other variables that reflect disease, disability, nutrition, or personal habits have less predictive ability. Most demographic factors are not predictors of expenditures in this population. Focusing on the best predictors may facilitate more-effective risk adjustment and creation of related health policies.

Original languageEnglish
Pages (from-to)371-379
Number of pages9
JournalJournal of the American Geriatrics Society
Volume51
Issue number3
DOIs
StatePublished - Mar 1 2003

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Health Resources
Health Expenditures
Medicare
Skinfold Thickness
Heart Diseases
Diabetes Mellitus
Women's Health
Demography
Independent Living
Risk Adjustment
Nursing Services
Baltimore
Aptitude
Health Policy
Serum Albumin
Chronic Obstructive Pulmonary Disease
Habits
Comorbidity
Inpatients
Creatinine

Keywords

  • Disabled persons
  • Health expenditures
  • Health services for the aged
  • Medicare
  • Women

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Predictors of health resource use by disabled older female medicare beneficiaries living in the community. / Weiner, Michael; Fan, Ming Yu; Johnson, Brent A.; Kasper, Judith D.; Anderson, Gerard F.; Fried, Linda P.

In: Journal of the American Geriatrics Society, Vol. 51, No. 3, 01.03.2003, p. 371-379.

Research output: Contribution to journalArticle

Weiner, Michael ; Fan, Ming Yu ; Johnson, Brent A. ; Kasper, Judith D. ; Anderson, Gerard F. ; Fried, Linda P. / Predictors of health resource use by disabled older female medicare beneficiaries living in the community. In: Journal of the American Geriatrics Society. 2003 ; Vol. 51, No. 3. pp. 371-379.
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