Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults.

ABSTRACT: OBJECTIVES:To examine the association between self-reported vision impairment (VI), hearing impairment (HI), and dual-sensory impairment (DSI), stratified by dementia status, on hospital admissions, hospice use, and healthcare costs. DESIGN:Retrospective analysis. SETTING:Medicare Current Beneficiary Survey from 1999 to 2006. PARTICIPANTS:Rotating panel of community-dwelling Medicare beneficiaries, aged 65?years and older (N?=?24 009). MEASUREMENTS:VI and HI were ascertained by self-report. Dementia status was determined by self-report or diagnosis codes in claims data. Primary outcomes included any inpatient admission over a 2-year period, hospice use over a 2-year period, annual Medicare fee-for-service costs, and total healthcare costs (which included information from Medicare claims data and other self-reported payments). RESULTS:Self-reported DSI was present in 30.2% (n?=?263/871) of participants with dementia and 17.8% (n?= 4112/23 138) of participants without dementia. In multivariable logistic regression models, HI, VI, or DSI was generally associated with increased odds of hospitalization and hospice use regardless of dementia status. In a generalized linear model adjusted for demographics, annual total healthcare costs were greater for those with DSI and dementia compared to those with DSI without dementia ($28 875 vs $3340, respectively). Presence of any sensory impairment was generally associated with higher healthcare costs. In a model adjusted for demographics, Medicaid status, and chronic medical conditions, DSI compared with no sensory impairment was associated with a small, but statistically significant, difference in total healthcare spending in those without dementia ($1151 vs $1056; P

SUBMITTER: Deardorff WJ 

PROVIDER: S-EPMC6684393 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature