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Medical cost trajectories and onsets of cancer and noncancer diseases in US elderly population.

ABSTRACT: Time trajectories of medical costs-associated with onset of twelve aging-related cancer and chronic noncancer diseases were analyzed using the National Long-Term Care Survey data linked to Medicare Service Use files. A special procedure for selecting individuals with onset of each disease was developed and used for identification of the date at disease onset. Medical cost trajectories were found to be represented by a parametric model with four easily interpretable parameters reflecting: (i) prediagnosis cost (associated with initial comorbidity), (ii) cost of the disease onset, (iii) population recovery representing reduction of the medical expenses associated with a disease since diagnosis was made, and (iv) acquired comorbidity representing the difference between post- and pre diagnosis medical cost levels. These parameters were evaluated for the entire US population as well as for the subpopulation conditional on age, disability and comorbidity states, and survival (2.5 years after the date of onset). The developed approach results in a family of new forecasting models with covariates.

SUBMITTER: Akushevich I

PROVIDER: S-EPMC3115464 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Medical cost trajectories and onsets of cancer and noncancer diseases in US elderly population.

Akushevich Igor I Kravchenko Julia J Akushevich Lucy L Ukraintseva Svetlana S Arbeev Konstantin K Yashin Anatoliy I AI

Computational and mathematical methods in medicine 20110601

Time trajectories of medical costs-associated with onset of twelve aging-related cancer and chronic noncancer diseases were analyzed using the National Long-Term Care Survey data linked to Medicare Service Use files. A special procedure for selecting individuals with onset of each disease was developed and used for identification of the date at disease onset. Medical cost trajectories were found to be represented by a parametric model with four easily interpretable parameters reflecting: (i) pre ...[more]

PMID: 21687557

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Project description:BackgroundWhether cognitive ageing trajectory is related to common functional deficits independent of initial cognitive function remains inconclusive. We aimed to explore the adverse health effect and potential predictive factors of distinct cognitive trajectories among Chinese older adults.MethodsThree thousand five hundred eighty-one community-dwelling older adults who completed three consecutive cognitive function examinations with the Mini-Mental State Examination (MMSE) over 5 years and were without cognitive impairment at enrollment were included. A group-based trajectory model was used to estimate cognitive ageing trajectories. Multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) were computed with logistic regression models to identify potential baseline determinants and health effect of cognitive trajectories on various adverse outcomes.ResultsTwo distinct cognitive ageing trajectories were identified with about 5.3% of the study participants ascribed to the rapidly decreasing group. Subjects with rapidly decreasing cognition showed significantly higher odds (OR, 95%CI) of experiencing frailty (4.04, 2.77-5.86), falls (2.01, 1.05-3.70), balance impairment (4.20, 2.75-6.38), high fall risk (5.66, 2.67-11.77) based on the Tinetti total score, disability in activities of daily living (1.76, 1.19-2.56), disability in instrumental activities of daily living (1.52, 1.05-2.19), and motor cognitive risk syndrome (2.24, 1.23-3.98) compared with their steadily decreasing counterparts. Individuals with older age, low education level, no marriage, high score of rapid eye movement behavior disorders, poor physical and cognitive function at baseline were more predisposed to an accelerated cognitive decline.ConclusionsFaster cognitive decline was independently associated with higher risk of multiple adverse events. Our findings put more emphasis on a routine and constant surveillance of cognitive function among community-dwelling older adults.

Dataset Information

Medical cost trajectories and onsets of cancer and noncancer diseases in US elderly population.

Publications

Medical cost trajectories and onsets of cancer and noncancer diseases in US elderly population.

Similar Datasets

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