Patterns of Healthcare Utilization and Spending Among Homebound Older Adults in the USA: an Observational Study - Journal of General Internal Medicine

Danmark Nyheder Nyheder

Patterns of Healthcare Utilization and Spending Among Homebound Older Adults in the USA: an Observational Study - Journal of General Internal Medicine
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We examined spending both in total per observation per year and by claim type. These claim types included inpatient, carrier , SNF, home health, outpatient, hospice, and durable medical equipment. We obtained information on Medicare reimbursements by hospital referral region from the Dartmouth Atlas.Statistical Analysis

Our unit of analysis was person-year and individuals were allowed to have repeat observations. This framework allowed us to increase our number of observations and account for the fact that an individual’s homebound status can change from year to year.We examined demographic and clinical characteristics of our observations by homebound status using bivariate linear or logistic regression.

We examined the sensitivity of our findings to high end-of-life spending by excluding from our sample those who died within 12 months of their NHATS interview. We explored the sensitivity of our findings to place of residence by excluding those residing in assisted living facilities. We also investigated the sensitivity of our findings to using person-years as our unit of observation by limiting the sample to one survey year , using the survey year with the largest sample size.

All analyses adjusted for NHATS analytic weights that consider survey design and differential probabilities of selection and non-response. All person-year analyses take into account clustering at the respondent level to account for repeat observations per respondent.The National Institute on Aging played no role in the design, conduct, and analysis of the study or in the decision to submit the manuscript for publication.

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