Resource use by younger versus older patients

Compared to younger persons, the elderly use disproportionately greater health care resources. We wondered if this difference persisted when care of both older and younger patients was managed by physicians of a single specialty, family practice.

The design was a retrospective analysis of a family practice clinical database. The setting was a 622-bed suburban teaching hospital. The subjects were all acute-care patients (112 short-stay unit and 232 hospitalized patients) cared for by a family practice residency service during a one-year period. The main outcome measures were site of care (inpatient versus short-stay unit), hospital length of stay, and in-hospital consultant use.

When cared for by the same physicians, the elderly are more likely to be admitted to the hospital rather than be successfully cared for in a short-stay unit (p = 0.001), to stay in the hospital longer (mean days: less than age 20 years, 5.1; age 80 and older, 8.5; p = 0.004), and to have a greater number of consultants (mean number of consultants: less than age 60 years, 0.80; age 60 and older, 1.16; p = 0.001).

Our study, in which patient care for patients of all ages was provided by one group of family practice residency physicians, indicated greater relative health care resource consumption by the elderly. We cannot exclude the possibility that age was simply a surrogate for unexplored factors, such as insurance status. The generalizability of a study from one group in one institution is limited.