Access to health care services for the disabled elderly

Area of Science:

• Gerontology
• Health Economics
• Rehabilitation Science

Background:

• Walking difficulty is a common limitation among elderly Medicare beneficiaries.
• Understanding the economic impact of mobility impairments is crucial for healthcare policy.

Purpose of the Study:

• To investigate the association between walking difficulty and compensatory strategies with downstream Medicare expenditures.
• To quantify the financial implications for the Medicare program.

Main Methods:

• Secondary analysis of Medicare claims data (1999-2000) linked with the 1999 National Long Term Care Survey (NLTCS).
• Longitudinal cohort study design.
• Statistical analysis to predict healthcare utilization and costs based on walking limitations and compensatory strategy use.

Main Results:

• Individuals with severe walking difficulty experienced increased home health visits and higher Medicare costs ($163-$222/month).
• Use of compensatory strategies (equipment, personal assistance) correlated with increased home health visits.
• Full compensation via equipment use was associated with lower Medicare costs compared to residual difficulty.

Conclusions:

• Walking difficulty and the use of compensatory strategies are significant predictors of Medicare service utilization.
• The findings highlight a substantial financial impact on the Medicare program due to mobility limitations in the elderly population.