Financial risk and hospital cost for elderly patients. Age- and non-age-stratified medical diagnosis related groups

• Published in: Archives of internal medicine (1960) Vol. 148; no. 4; p. 909
• Main Authors: Muñoz, E, Rosner, F, Chalfin, D, Goldstein, J, Margolis, I B, Wise, L
• Format: Journal Article
• Language: English
• Published: United States 01-04-1988
• Subjects: Aged; Aged, 80 and over; Costs and Cost Analysis; Diagnosis-Related Groups - economics; Financial Management; Financial Management, Hospital; Hospital Bed Capacity, 500 and over; Hospitals - statistics & numerical data; Hospitals, Urban - statistics & numerical data; Humans; Length of Stay - economics; Medicare - statistics & numerical data; Middle Aged; New York City; Risk
• ISSN: 0003-9926
• DOI: 10.1001/archinte.1988.00380040149021

The purpose of this study was to analyze hospital resource consumption for Medicare patients in non-age- and age-stratified medical diagnosis related groups (DRGs). This study of patients in 74 non-age-stratified DRGs (N = 3643) and 113 age-stratified DRGs (N = 2898) demonstrated that older medical patients (usually greater than or equal to 75 to 80 years of age) had (on average) higher total hospital costs, a longer hospital length of stay, more diagnoses per patient, a greater percentage of outliers, and a higher mortality compared with younger patients in these same DRGs. These findings raise the question of the equity of DRG payment vis-à-vis older Medicare patients in both non-age- and age-stratified medical DRGs. Financial disincentives to treat older medical patients may limit both their access and quality of care in the future.