Consequences of preventing delirium in hospitalized older adults on nursing home costs

Douglas Leslie, Ying Zhang, Sidney T. Bogardus, Theodore R. Holford, Linda S. Leo-Summers, Sharon K. Inouye

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

OBJECTIVES: To determine whether costs of long-term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention. DESIGN: Longitudinal follow-up from a randomized trial. SETTING: Posthospital discharge settings: community-based care and NHs. PARTICIPANTS: Eight hundred one hospitalized patients aged 70 and older. MEASUREMENTS: Patients were followed for 1 year after discharge, and measures of NH service use and costs were constructed. Total long-term NH costs were estimated using a two-part regression model and compared across intervention and control groups. RESULTS: Of the 400 patients in the intervention group and 401 patients in the matched control group, 153 (38%) and 148 (37%), respectively, were admitted to a NH during the year, and 54 (13%) and 51 (13%), respectively, were long-term NH patients. The MTI had no effect on the likelihood of receiving long-term NH care, but of patients receiving long-term NH care, those in the MTI group had significantly lower total costs, shorter length of stay and lower cost per survival day. Adjusted total costs were $50,881 per long-term NH patient in the MTI group and $60,327 in the control group, a savings of 15.7% (P = .01). CONCLUSION: Active methods to prevent delirium are associated with a 15.7% decrease in long-term NH costs. Shorter length of stay of patients receiving long-term NH services was the primary source of these savings.

Original languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalJournal of the American Geriatrics Society
Volume53
Issue number3
DOIs
StatePublished - Mar 1 2005

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Delirium
Nursing Homes
Costs and Cost Analysis
Home Care Services
Nursing Care
Nursing Services
Control Groups
Length of Stay
Research Design
Survival

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Leslie, Douglas ; Zhang, Ying ; Bogardus, Sidney T. ; Holford, Theodore R. ; Leo-Summers, Linda S. ; Inouye, Sharon K. / Consequences of preventing delirium in hospitalized older adults on nursing home costs. In: Journal of the American Geriatrics Society. 2005 ; Vol. 53, No. 3. pp. 405-409.
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abstract = "OBJECTIVES: To determine whether costs of long-term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention. DESIGN: Longitudinal follow-up from a randomized trial. SETTING: Posthospital discharge settings: community-based care and NHs. PARTICIPANTS: Eight hundred one hospitalized patients aged 70 and older. MEASUREMENTS: Patients were followed for 1 year after discharge, and measures of NH service use and costs were constructed. Total long-term NH costs were estimated using a two-part regression model and compared across intervention and control groups. RESULTS: Of the 400 patients in the intervention group and 401 patients in the matched control group, 153 (38{\%}) and 148 (37{\%}), respectively, were admitted to a NH during the year, and 54 (13{\%}) and 51 (13{\%}), respectively, were long-term NH patients. The MTI had no effect on the likelihood of receiving long-term NH care, but of patients receiving long-term NH care, those in the MTI group had significantly lower total costs, shorter length of stay and lower cost per survival day. Adjusted total costs were $50,881 per long-term NH patient in the MTI group and $60,327 in the control group, a savings of 15.7{\%} (P = .01). CONCLUSION: Active methods to prevent delirium are associated with a 15.7{\%} decrease in long-term NH costs. Shorter length of stay of patients receiving long-term NH services was the primary source of these savings.",
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Consequences of preventing delirium in hospitalized older adults on nursing home costs. / Leslie, Douglas; Zhang, Ying; Bogardus, Sidney T.; Holford, Theodore R.; Leo-Summers, Linda S.; Inouye, Sharon K.

In: Journal of the American Geriatrics Society, Vol. 53, No. 3, 01.03.2005, p. 405-409.

Research output: Contribution to journalArticle

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AU - Leslie, Douglas

AU - Zhang, Ying

AU - Bogardus, Sidney T.

AU - Holford, Theodore R.

AU - Leo-Summers, Linda S.

AU - Inouye, Sharon K.

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N2 - OBJECTIVES: To determine whether costs of long-term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention. DESIGN: Longitudinal follow-up from a randomized trial. SETTING: Posthospital discharge settings: community-based care and NHs. PARTICIPANTS: Eight hundred one hospitalized patients aged 70 and older. MEASUREMENTS: Patients were followed for 1 year after discharge, and measures of NH service use and costs were constructed. Total long-term NH costs were estimated using a two-part regression model and compared across intervention and control groups. RESULTS: Of the 400 patients in the intervention group and 401 patients in the matched control group, 153 (38%) and 148 (37%), respectively, were admitted to a NH during the year, and 54 (13%) and 51 (13%), respectively, were long-term NH patients. The MTI had no effect on the likelihood of receiving long-term NH care, but of patients receiving long-term NH care, those in the MTI group had significantly lower total costs, shorter length of stay and lower cost per survival day. Adjusted total costs were $50,881 per long-term NH patient in the MTI group and $60,327 in the control group, a savings of 15.7% (P = .01). CONCLUSION: Active methods to prevent delirium are associated with a 15.7% decrease in long-term NH costs. Shorter length of stay of patients receiving long-term NH services was the primary source of these savings.

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