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April 1988

Financial Risk and Hospital Cost for Elderly Patients: Age- and Non—Age-Stratified Medical Diagnosis Related Groups

Author Affiliations

From the Departments of Medicine (Drs Rosner and Chalfin) and Surgery (Dr Margolis), Queens Hospital Center, Jamaica, NY; the Long Island Jewish Medical Center, New Hyde Park, NY (Drs Muñoz and Wise and Mr Goldstein); State University of New York—Health Science Center, Stony Brook, NY; and City University School of New York School of Medicine.

Arch Intern Med. 1988;148(4):909-912. doi:10.1001/archinte.1988.00380040149021

• The purpose of this study was to analyze hospital resource consumption for Medicare patients in non—age- and age-stratified medical diagnosis related groups (DRGs). This study of patients in 74 non—age-stratified DRGs (N = 3643) and 113 age-stratified DRGs (N = 2898) demonstrated that older medical patients (usually ≥75 to 80 years of age) had (on average) higher total hospital costs, a longer hospital length of stay, more diagnoses per patient, a greater percentage of outliers, and a higher mortality compared with younger patients in these same DRGs. These findings raise the question of the equity of DRG payment vis-à-vis older Medicare patients in both non—age- and age-stratified medical DRGs. Financial disincentives to treat older medical patients may limit both their access and quality of care in the future.

(Arch Intern Med 1988;148:909-912)