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Healthcare costs for people aged 65+ two years prior to their receiving long-term municipal care

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Abstract

Background and aims: More knowledge is needed about patterns of healthcare consumption at different times during old age, particularly with regard to the relationship between various agents in the healthcare and social services system. One aim was to investigate healthcare costs in the public medical healthcare system in men and women (65+) and, with regard to age, in the two years prior to the start of long-term municipal care and services. Another aim was to investigate patterns and determinants of costs. Methods: The study comprised 362 people who received decisions about municipal care and/or services during 2002–2003, and data were derived from the Swedish National Study of Aging and Care (SNAC) and county councils registers about healthcare consumption. SNAC provided data concerning demographics, functional dependency and informal care at the time of the decision, which were merged with data from the Skåne County Council patient administrative system regarding costs in the two years prior to decision. Results: Cluster analysis revealed 13% overall higher healthcare costs. Those involved were more often younger, men, married, and diagnosed with circulatory diseases, cancer, or injuries. Most (58% for women, 54% for men) of the costs for acute inpatient care occurred within five months prior to municipal care. Men had significantly higher costs compared with women for visits to outpatient physicians (EUR 700 vs 400) and inpatient care (EUR 4700 vs 700) 12-0 months prior to municipal care. Conclusions: A share of 13% had higher healthcare costs throughout the two years. Those involved were more often younger, men, married, and diagnosed with circulatory diseases, cancer, or injuries. Those older people at risk of high healthcare costs should benefit from systematic clinical assessments and more proactive and integrated care, to prevent escalating costs in the period preceding long-term municipal care and services.

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References

  1. Kristensson J, Hallberg E, Jakobsson U. Healthcare consumption in men and women aged 65 and above in the two years preceding a decision about long-term municipal care. Health Soc Care Commun 2007; 15: 474–85.

    Article  Google Scholar 

  2. National Board of Health and Welfare (Socialstyrelsen). Care and Services for elderly. Report 2004 (Vård och omsorg om äldre. Lägesrapport 2004. In Swedish). Stockholm, Sweden: The National Board of Health and Welfare, 2004.

    Google Scholar 

  3. Åhgren B. Developing and managing integrated care in Sweden: the unbroken chain of care. In Vaarama M, Pieper R, eds. Managing integrated care for older people: European perspectives and good practices. Helsinki: Stakes & EHMA, 2005.

    Google Scholar 

  4. Electronic material (National Center for Health Statistics. Personal healthcare expenditures of medicare beneficiaries by source of payment, type of service, sex, race/ethnicity, residence and age, from the Medicare current beneficiary survey, 1992–2003 (MCESP03)). Available at: http://209.217.72.34/aging/TableViewer/summary.aspx (2007-03-05).

  5. Hellström Y, Hallberg IR. Perspective of elderly people receiving home help on health, care and quality of life. Health Soc Care Commun 2001; 9: 61–71.

    Article  Google Scholar 

  6. Leon J, Neumann PJ. The cost of Alzheimer’s disease in managed care: A cross-sectional study. Am J Manag Care 1999; 5: 867–77.

    PubMed  CAS  Google Scholar 

  7. Haentjens P, Autier P, Barette M, Boonen S. Costs of care after hospital discharge among women with a femoral neck fracture. Clin Orthop Relat Res 2003; 414: 250–8.

    Article  PubMed  Google Scholar 

  8. Caro J, Huybrechts KF, Kelley HE. Predicting treatment costs after acute ischemic stroke on the basis of patient characteristics at presentation and early dysfunction. Stroke 2001; 32: 100–11.

    Article  PubMed  CAS  Google Scholar 

  9. National Center for Health Statistics. Health, United States, 2006. With chartbook on trends in the health of Americans. MD, USA: Hyattsville, 2007.

    Google Scholar 

  10. Pollicino C, Saltman DC. The relationship between physician cost and functional status in the elderly. Int J Qual Health Care 2000; 5: 425–31.

    Article  Google Scholar 

  11. Alemayehu B, Warner KE. The lifetime distribution of health care costs. Health Serv Res 2004; 39: 627–39.

    Article  PubMed  Google Scholar 

  12. Linjer E, Jörnmark J, Hedner T, Jönsson B. Predictors for high costs of hospital care in elderly hypertensive patients. Blood Press 2006; 15: 245–50.

    Article  PubMed  Google Scholar 

  13. Lagergren M. The system of care for frail elderly persons: The case of Sweden. Aging Clin Exp Res 2002; 14: 252–7.

    Article  PubMed  Google Scholar 

  14. National board of Health and Welfare. Current development in the care for the elderly in Sweden. Stockholm, Sweden: The National Board of Health and Welfare, 2007.

    Google Scholar 

  15. Lagergren M, Fratiglioni L, Hallberg IR et al. A longitudinal study integrating population, care and social services data. The Swedish National Study on Aging and Care (SNAC). Aging Clin Exp Res 2004; 16: 158–68.

    Article  PubMed  Google Scholar 

  16. Jakobsson U, Hallberg IR. Mortality among elderly receiving long-term care: A longitudinal cohort study. Aging Clin Exp Res 2006; 18: 503–10.

    PubMed  Google Scholar 

  17. Electronic material (Statistics Sweden). Population in the country, counties and municipalities based on gender and age 2006-12-31 (Folkmä’ngd i riket, lä’n och kommuner efter kön och åider 2006-12-31 (In Swedish)). Available: http://www.scb.se/templates/tableOrChart_159277.asp (2007-10-28).

  18. Asberg K, Sonn U. The cumulative structure of personal and instrumental ADL. A study of elderly people in a health service district. Scand J Rehabil Med 1989; 21: 171–7.

    CAS  Google Scholar 

  19. Electronic material (National Board of Health and Wefare (Socialstyrelsen). What is DRG? (Vad är DRG? In Swedish)) Available at: http://www.socialstyrelsen.se/Om_Sos/organisation/Epidemiologiskt_Centrum/Enheter/CPK-PAR/vad_DRG.htm (2007-10-28).

  20. The Region of Skåne (Region Skåne). Costs 2004 for health and medical care for the population of Skåne (Kostnader 2004 för hälso- och sjukvård för befolkningen i Skåne. In Swedish). Lund, Sweden: Region Skåne, 2005.

    Google Scholar 

  21. Altman DG. Practical Statistics for Medical Research. London: Chapman & Hall, 1991.

    Google Scholar 

  22. Hendriksen C, Lund E, Stromgard E. Consequences of assessment and intervention among elderly people: a three year randomised controlled trial. BMJ 1984; 289: 1522–4.

    Article  PubMed  CAS  Google Scholar 

  23. Bernabei R, Landi F, Gambassi G et al. Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ 1998; 316: 1348–51.

    Article  PubMed  CAS  Google Scholar 

  24. Condelius A, Edberg AK, Jakobsson U, Hallberg IR. Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care. Arch Gerontol Geriatr 2008: 46: 41–55.

    Article  PubMed  Google Scholar 

  25. Werntoft E, Hallberg IR, Edberg AK. Older people’s reasoning about age-related prioritization in health care. Nurs Ethics 2007; 14: 399–412.

    Article  PubMed  Google Scholar 

  26. Kinsella K, Velkoff VA. An Aging World: 2001. U.S. Census Bureau, Washington, DC. U.S. Government Printing Office, 2001.

    Google Scholar 

  27. Bolin K, Lindgren B, Lundborg P. Informal and formal care among single-living elderly in Europe. Health Econ 2008, 17; 393–409.

    Article  PubMed  CAS  Google Scholar 

  28. Kazdin A. Research Design in Clinical Psychology. Boston, USA: Allyn & Bacon, 2003.

    Google Scholar 

  29. Hallberg IR, Karlsson S, Westergren A, Dozet A et al. Municipal and regional care for the elderly. Care and Services in Eslöv, Hässleholm, Malmö, Osby and Ystad for people aged 65 and above, spring 2001. A study in SNAC. Report 1. (Kommunal och Regional vård till äldre. Vård och omsorg i Eslöv, Hässleholm, Malmö, Osby och Ystad, våren 2001. En delstudie i SNAC. Rapport 1. In Swedish). Lund, Sweden: Lund University, 2002.

    Google Scholar 

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Correspondence to Jimmie Kristensson RN, PhD.

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Kristensson, J., Hallberg, I.R. & Lundborg, P. Healthcare costs for people aged 65+ two years prior to their receiving long-term municipal care. Aging Clin Exp Res 20, 547–555 (2008). https://doi.org/10.1007/BF03324883

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