Patients Matter More

Medicare costs driven by patient characteristics

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A new study finds that the variation in Medicare costs across the United States is driven by patient characteristics more than by regional factors, such as the number of beds available.

Researchers from Mount Sinai School of Medicine and the University of California, Los Angeles (UCLA) analyzed the health records of 2,400 older adults from regions around the United States in order to find out which factors contributed to Medicare costs in the last six months of their lives. The researchers also examined the characteristics of the local healthcare system where these older individuals resided.

The researchers found that patient characteristics - such as the ability to function, the severity of their illness, and family support - were stronger predictors of Medicare expenses than regional factors. More specifically, patient characteristics accounted for 10 percent of the variation in Medicare costs, while regional factors - such as the amount of hospital beds - explained for only five percent of the variation.

According to lead author Amy Kelley, M.D., Assistant Professor in the Department of Geriatrics and Palliative Medicine at Mount Sinai School of Medicine, these findings suggest that the variation in Medicare costs across the U.S. is a much more complex issue that previously thought. Therefore, future research should address how factors such as having a family nearby can lower Medicare expenses, said senior author Catherine Sarkisian, M.D., Associate Professor in the Division of Geriatrics at UCLA.

Searching for answers to the questions raised by this study (such as the one posed above by Dr. Sarkisian) will help to improve the care of the most complicated patients. According to Dr. Kelley, healthcare reform will be most effective in reducing costs if health care providers focus on delivering well-coordinated, high-quality care to these complicated patients.

Medicare is a government-run health insurance program that provides health care to 47 million seniors (age 65 and older) and younger people with disabilities.

The study is published in The Annals of Internal Medicine.

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Review Date: 
February 15, 2011
Last Updated:
February 16, 2011