The effect of age and procedure on resource use for patients with cerebrovascular disease
Kazuaki Kuwabara1, Shinya Matsuda, Yuichi Imanaka
1Department of Health Care Administration and Management, Graduate School of Medicine, Kyushu University, Maidahi Higashiku, Fukuoka, Japan. kazu228@basil.ocn.ne.jp
Insights
Population ageing does not significantly impact total healthcare charges for cerebrovascular disease (CVD). Procedures, not age, are the primary driver of healthcare costs in CVD patients, necessitating a focus on procedural economic evaluations.
Area of Science:
- Health Economics
- Gerontology
- Neurology
Background:
- Population ageing is a significant global demographic trend.
- Healthcare expenditures are rising, with a notable impact from an ageing population.
- Previous research has not fully assessed the impact of ageing on specific disease costs, adjusted for severity and procedures.
Purpose of the Study:
- To examine the relationship between an ageing population and resource utilization in patients with cerebrovascular disease (CVD).
- To determine the independent effects of age on length of stay (LOS) and total charges.
- To analyze the influence of specific procedures on healthcare costs in CVD patients across different age groups.
Main Methods:
- Analysis of 13,856 CVD patients from 82 academic and 92 community hospitals.
- Stratification of patients into age groups: under 65, 65-74, and 75 years or older.
- Multivariate analysis to determine the independent effects of age and procedures on LOS and total charges.
Main Results:
- Age and procedures were significantly associated with length of stay (LOS), with procedures having a greater impact.
- While age showed no significant association with total charges, procedures were highly associated with overall costs.
- Mortality rates varied significantly by age group, with higher rates in the 75 years or older category.
Conclusions:
- Ageing populations do not have a significant direct impact on the total healthcare charges for cerebrovascular disease.
- Healthcare policy-makers should prioritize the economic impact of medical procedures in cost analyses.
- Monitoring and evaluating the use of procedures is crucial for managing healthcare costs in cerebrovascular disease.
Objective:
Many studies have described the impact of population ageing on health care expenditures, but few have assessed its impact on specific diseases adjusted for severity and procedure. This study examined the relationship between an ageing population and resource use in patients with cerebrovascular disease (CVD).
Methods:
A total of 13,856 CVD patients were treated in 82 academic and 92 community hospitals. Demographic variables, clinical variables, length of stay (LOS) and total charges were analysed by age group (under 65 years, 65-74 years and 75 years or older). The independent effects of age on LOS and total charge were determined using multivariate analysis.
Results:
There were 5172 (37%) patients under 65 years of age, 4096 (30%) 65-74 years and 4588 (33%) 75 years or older. Intracranial infarction or ischaemia was diagnosed in 69% of the patients, haemorrhage in 23% and subarachnoid haemorrhage in 9%. The overall mortality was 6% (5% in under 65 years, 5% in 65-74 years and 9% in 75 years or older; P<0.001). There were significant differences in the proportion of procedures performed in each age category. Age and procedure were significantly associated with LOS, particularly the latter. Age had no significant association with total charge, but procedure was highly associated.
Conclusions:
Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures.
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