Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries.
<h4>Objectives</h4>To examine Medicare health care spending and health services utilization among high-need population segments in older Mexican Americans, and to examine the association of frailty on health care spending and utilization.<h4>Methods</h4>Retrospective cohort s...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0262079 |
| _version_ | 1831517310774411264 |
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| author | Maricruz Rivera-Hernandez Amit Kumar Lin-Na Chou Tamra Keeney Nasim Ferdows Amol Karmarkar Kyriakos S Markides Kenneth Ottenbacher |
| author_facet | Maricruz Rivera-Hernandez Amit Kumar Lin-Na Chou Tamra Keeney Nasim Ferdows Amol Karmarkar Kyriakos S Markides Kenneth Ottenbacher |
| author_sort | Maricruz Rivera-Hernandez |
| collection | DOAJ |
| description | <h4>Objectives</h4>To examine Medicare health care spending and health services utilization among high-need population segments in older Mexican Americans, and to examine the association of frailty on health care spending and utilization.<h4>Methods</h4>Retrospective cohort study of the innovative linkage of Medicare data with the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) were used. There were 863 participants, which contributed 1,629 person years of information. Frailty, cognition, and social risk factors were identified from the H-EPESE, and chronic conditions were identified from the Medicare file. The Cost and Use file was used to calculate four categories of Medicare spending on: hospital services, physician services, post-acute care services, and other services. Generalized estimating equations (GEE) with a log link gamma distribution and first order autoregressive, correlation matrix was used to estimate cost ratios (CR) of population segments, and GEE with a logit link binomial distribution was applied to estimate odds ratios (OR) of healthcare use.<h4>Results</h4>Participants in the major complex chronic illness segment who were also pre-frail or frail had higher total costs and utilization compared to the healthy segment. The CR for total Medicare spending was 3.05 (95% CI, 2.48-3.75). Similarly, this group had higher odds of being classified in the high-cost category 5.86 (95% CI, 3.35-10.25), nursing home care utilization 11.32 (95% CI, 3.88-33.02), hospitalizations 4.12 (95% CI, 2.88-5.90) and emergency room admissions 4.24 (95% CI, 3.04-5.91).<h4>Discussion</h4>Our findings highlight that frailty assessment is an important consideration when identifying high-need and high-cost patients. |
| first_indexed | 2024-12-10T18:14:48Z |
| format | Article |
| id | doaj.art-f9aa219ca1654771ab093744d1b70dc2 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T18:14:48Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f9aa219ca1654771ab093744d1b70dc22022-12-22T01:38:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01171e026207910.1371/journal.pone.0262079Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries.Maricruz Rivera-HernandezAmit KumarLin-Na ChouTamra KeeneyNasim FerdowsAmol KarmarkarKyriakos S MarkidesKenneth Ottenbacher<h4>Objectives</h4>To examine Medicare health care spending and health services utilization among high-need population segments in older Mexican Americans, and to examine the association of frailty on health care spending and utilization.<h4>Methods</h4>Retrospective cohort study of the innovative linkage of Medicare data with the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) were used. There were 863 participants, which contributed 1,629 person years of information. Frailty, cognition, and social risk factors were identified from the H-EPESE, and chronic conditions were identified from the Medicare file. The Cost and Use file was used to calculate four categories of Medicare spending on: hospital services, physician services, post-acute care services, and other services. Generalized estimating equations (GEE) with a log link gamma distribution and first order autoregressive, correlation matrix was used to estimate cost ratios (CR) of population segments, and GEE with a logit link binomial distribution was applied to estimate odds ratios (OR) of healthcare use.<h4>Results</h4>Participants in the major complex chronic illness segment who were also pre-frail or frail had higher total costs and utilization compared to the healthy segment. The CR for total Medicare spending was 3.05 (95% CI, 2.48-3.75). Similarly, this group had higher odds of being classified in the high-cost category 5.86 (95% CI, 3.35-10.25), nursing home care utilization 11.32 (95% CI, 3.88-33.02), hospitalizations 4.12 (95% CI, 2.88-5.90) and emergency room admissions 4.24 (95% CI, 3.04-5.91).<h4>Discussion</h4>Our findings highlight that frailty assessment is an important consideration when identifying high-need and high-cost patients.https://doi.org/10.1371/journal.pone.0262079 |
| spellingShingle | Maricruz Rivera-Hernandez Amit Kumar Lin-Na Chou Tamra Keeney Nasim Ferdows Amol Karmarkar Kyriakos S Markides Kenneth Ottenbacher Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. PLoS ONE |
| title | Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. |
| title_full | Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. |
| title_fullStr | Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. |
| title_full_unstemmed | Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. |
| title_short | Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries. |
| title_sort | healthcare utilization and costs among high need and frail mexican american medicare beneficiaries |
| url | https://doi.org/10.1371/journal.pone.0262079 |
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