A Longitudinal Analysis of Total 3-Year Healthcare Costs for Older Adults Who Experience a Fall Requiring Medical Care
A Longitudinal Analysis of Total 3-Year Healthcare Costs for Older Adults Who Experience a Fall Requiring Medical Care
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DOI：
10.1111/j.1532-5415.2010.02816.x
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发表时间：
2010-05-01
影响因子：
6.3
通讯作者：
Phelan, Elizabeth A.
中科院分区：
文献类型：
--
作者：
Bohl, Alex A.;Fishman, Paul A.;Phelan, Elizabeth A.
比较跌倒时入院的跌倒者之间医疗费用的纵向变化（入院），未入院者（nonadmitted），和nonfaller控制;测试假设相关的差异，平均成本之间和这些组内随着时间的推移;并估计可归因于下降的成本。纵向队列研究。地点普吉特海湾团体健康合作社。参与者：万九百93名未入院的跌倒者、976名入院的跌倒者和8，956名年龄在67岁及以上的未入院的跌倒者参加了一个综合保健提供系统。根据2004年1月1日至2006年12月31日期间记录的与跌倒相关的E代码和国际疾病分类第九次修订代码确定跌倒者。Nonfallers的频率匹配的年龄组和sex. MEASUMENTSQuarterly成本在3年期间使用广义估计方程进行建模。协变量包括指数年龄、性别、RxRisk（一种共病调节因子）、跌倒状态、时间以及跌倒状态和时间之间的相互作用。
OBJECTIVESTo compare longitudinal changes in healthcare costs between fallers admitted to the hospital at the time of the fall (admitted), those not admitted to the hospital (nonadmitted), and nonfaller controls; test hypotheses related to differences in mean costs between and within these groups over time; and estimate the costs attributable to falling.DESIGNLongitudinal cohort.SETTINGGroup Health Cooperative of Puget Sound.PARTICIPANTSSeven thousand nine hundred ninety-three nonadmitted fallers, 976 admitted fallers, and 8,956 nonfallers aged 67 and older enrolled in an integrated healthcare delivery system. Fallers were identified according to fall-related E-Codes and International Classification of Diseases, Ninth Revision codes recorded between January 1, 2004, and December 31, 2006. Nonfallers were frequency matched on age group and sex.MEASUREMENTSQuarterly costs during a 3-year period were modeled using generalized estimating equations. Covariates included index age, sex, RxRisk (a comorbidity adjuster), fall status, time, and interactions between fall status and time.RESULTSCost differences between the faller cohorts and nonfallers were greatest in quarters closest to the fall (all P