Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly

作者：Jennifer L. Wolff, Barbara H. Starfield, Gerard F. Anderson · 发表于：Archives of Internal Medicine · 年份：2002 · DOI：10.1001/archinte.162.20.2269 · 被引用次数：2289 · 研究领域：Chronic Disease Management Strategies、Primary Care and Health Outcomes、Diabetes Management and Education

BACKGROUND: The prevalence, health care expenditures, and hospitalization experiences are important considerations among elderly populations with multiple chronic conditions. METHODS: A cross-sectional analysis was conducted on a nationally random sample of 1 217 103 Medicare fee-for-service beneficiaries aged 65 and older living in the United States and enrolled in both Medicare Part A and Medicare Part B during 1999. Multiple logistic regression was used to analyze the influence of age, sex, and number of types of chronic conditions on the risk of incurring inpatient hospitalizations for ambulatory care sensitive conditions and hospitalizations with preventable complications among aged Medicare beneficiaries. RESULTS: In 1999, 82% of aged Medicare beneficiaries had 1 or more chronic conditions, and 65% had multiple chronic conditions. Inpatient admissions for ambulatory care sensitive conditions and hospitalizations with preventable complications increased with the number of chronic conditions. For example, Medicare beneficiaries with 4 or more chronic conditions were 99 times more likely than a beneficiary without any chronic conditions to have an admission for an ambulatory care sensitive condition (95% confidence interval, 86-113). Per capita Medicare expenditures increased with the number of types of chronic conditions from $211 among beneficiaries without a chronic condition to $13 973 among beneficiaries with 4 or more types of chronic conditions. CONCLUSIONS: The ris...