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Health care and medication costs and use among older adults with heart failure.
Am J Med. 2004 Apr 01; 116(7):443-50.AJ

Abstract

BACKGROUND

Heart failure disproportionately affects older adults for whom multiple medications are prescribed to prevent exacerbations and hospitalization. To target interventions effectively, it is important to understand the association of medication acquisition with health care utilization and costs.

METHODS

We used electronic medical records from an urban public health care system to identify patients aged >/=50 years who had a diagnosis of heart failure. We assessed the association between inappropriate or appropriate medication supplies and hospitalization and costs using multivariable analyses that adjusted for demographic characteristics, prior health care use, health status, and insurance status.

RESULTS

Total health care costs for treating 1554 patients with heart failure from 1996 to 2000 were 36.6 million dollars (in 2000 dollars). Less than a third of patients received appropriate medication supplies (between 90% and 110% of the supplies needed) annually. Compared with patients with appropriate supplies, the odds of hospitalization were greater among those with undersupplies (odds ratio [OR] = 3.1; 95% confidence interval [CI]: 2.3 to 4.2; P <0.0001) or oversupplies (OR = 2.0; 95% CI: 1.7 to 2.4; P <0.0001). Total costs were 25% higher for patients with undersupplies (95% CI: 8% to 46%; P = 0.004) and 18% higher for those with oversupplies (95% CI: 7% to 30%; P = 0.0009) than for those with appropriate supplies.

CONCLUSION

Among adults with heart failure, inappropriate medication supplies were associated with increased hospitalization and higher costs. Monitoring medication supplies from electronic medical records may be a useful component of programs aiming to improve care while managing costs.

Authors+Show Affiliations

Midwest Center for Health Services and Policy Research, Hines VA Hospital, Illinois 60141-5151, USA. Stroupe@research.hines.med.va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15047033

Citation

Stroupe, Kevin T., et al. "Health Care and Medication Costs and Use Among Older Adults With Heart Failure." The American Journal of Medicine, vol. 116, no. 7, 2004, pp. 443-50.
Stroupe KT, Teal EY, Weiner M, et al. Health care and medication costs and use among older adults with heart failure. Am J Med. 2004;116(7):443-50.
Stroupe, K. T., Teal, E. Y., Weiner, M., Gradus-Pizlo, I., Brater, D. C., & Murray, M. D. (2004). Health care and medication costs and use among older adults with heart failure. The American Journal of Medicine, 116(7), 443-50.
Stroupe KT, et al. Health Care and Medication Costs and Use Among Older Adults With Heart Failure. Am J Med. 2004 Apr 1;116(7):443-50. PubMed PMID: 15047033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health care and medication costs and use among older adults with heart failure. AU - Stroupe,Kevin T, AU - Teal,Evgenia Y, AU - Weiner,Michael, AU - Gradus-Pizlo,Irmina, AU - Brater,D Craig, AU - Murray,Michael D, PY - 2003/06/02/received PY - 2003/11/04/revised PY - 2003/11/04/accepted PY - 2004/3/30/pubmed PY - 2004/4/27/medline PY - 2004/3/30/entrez SP - 443 EP - 50 JF - The American journal of medicine JO - Am. J. Med. VL - 116 IS - 7 N2 - BACKGROUND: Heart failure disproportionately affects older adults for whom multiple medications are prescribed to prevent exacerbations and hospitalization. To target interventions effectively, it is important to understand the association of medication acquisition with health care utilization and costs. METHODS: We used electronic medical records from an urban public health care system to identify patients aged >/=50 years who had a diagnosis of heart failure. We assessed the association between inappropriate or appropriate medication supplies and hospitalization and costs using multivariable analyses that adjusted for demographic characteristics, prior health care use, health status, and insurance status. RESULTS: Total health care costs for treating 1554 patients with heart failure from 1996 to 2000 were 36.6 million dollars (in 2000 dollars). Less than a third of patients received appropriate medication supplies (between 90% and 110% of the supplies needed) annually. Compared with patients with appropriate supplies, the odds of hospitalization were greater among those with undersupplies (odds ratio [OR] = 3.1; 95% confidence interval [CI]: 2.3 to 4.2; P <0.0001) or oversupplies (OR = 2.0; 95% CI: 1.7 to 2.4; P <0.0001). Total costs were 25% higher for patients with undersupplies (95% CI: 8% to 46%; P = 0.004) and 18% higher for those with oversupplies (95% CI: 7% to 30%; P = 0.0009) than for those with appropriate supplies. CONCLUSION: Among adults with heart failure, inappropriate medication supplies were associated with increased hospitalization and higher costs. Monitoring medication supplies from electronic medical records may be a useful component of programs aiming to improve care while managing costs. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/15047033/Health_care_and_medication_costs_and_use_among_older_adults_with_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002934303007770 DB - PRIME DP - Unbound Medicine ER -