Profiles of Older Medicare Decedents

• June R. Lunney

• Joanne Lynn

• Christopher Hogan

抄録

OBJECTIVES: To evaluate the usefulness of a clinical scheme to classify older decedents to better understand the issues associated with healthcare use and costs in the last year of life. DESIGN: We analyzed Medicare claims data for a random sample of 0.1% of all Medicare beneficiaries with expenditures between 1993 and 1998. This sample yielded 7,966 deaths. SETTING: Medicare claims data. PARTICIPANTS: Medicare beneficiaries. MEASUREMENTS: We classified decedents into groups representing four trajectories at the end of life: sudden death, terminal illness, organ failure, and frailty. RESULTS: Ninety‐two percent of decedents were captured by the profiling strategy. The four trajectory groups had distinct patterns of demographics, care delivery, and Medicare expenditures. Frailty was a dominant pattern, with 47% of all decedents, whereas sudden death claimed only 7%; cancer claimed 22%, and organ system failure, 16%. CONCLUSIONS: The clinical scheme to classify decedents appears to fit most decedents and to form groups with substantial clinical differences. Acknowledging the differences among these groups may be a fruitful way to evaluate expenditures and develop strategies to improve care at the end of life.

収録刊行物

• Journal of the American Geriatrics Society

  Journal of the American Geriatrics Society 50 (6), 1108-1112, 2002-06

  Wiley

キーワード

• Geriatrics and Gerontology

詳細情報

• CRID: 1363670318972250880
• NII論文ID: 30014945906
• DOI: 10.1046/j.1532-5415.2002.50268.x
• ISSN: 15325415
• ISSN: 00028614
• Web Site: https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1046%2Fj.1532-5415.2002.50268.x
• Web Site: http://onlinelibrary.wiley.com/wol1/doi/10.1046/j.1532-5415.2002.50268.x/fullpdf
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