Article Figures & Data
Figures
- Figure 1.
Hospitalization Rates before and after Geriatric Intervention.
Tables
- Table 1.
Baseline Demographic, Clinical, and Utilization Characteristics of Intervention Subjects and Matched Controls
Characteristic Intervention (N=146) Control (N=437) P Value Demographic characteristics Age, y, mean (SD) 78.6 (8.2) 77.3 (7.9) .09 Female, n (%) 96 (66) 287 (66) .99 Census-linked socioeconomic characteristics* Median household income, mean 54,580 54,370 .90 Proportion of adults who graduated from high school, mean (SD) 0.88 (0.09) 0.88 (0.08) .55 Proportion of adults of non-white race, mean (SD) 0.17 (0.15) 0.22 (0.19) .01 Clinical characteristics Diabetes, n (%) 36 (25) 107 (25) .97 Heart disease, n (%) 58 (40) 140 (32) .09 Cancer diagnosis, n (%) None 118 (81) 362 (83) Within 5 years 13 (9) 34 (8) .94 5–10 years from index date 9 (6) 23 (5) >10 years from index date 6 (4) 18 (4) Dementia or Parkinson’s Disease, n (%) 16 (11) 27 (6) .06 Recent depression, n (%) 4 (3) 10 (2) .76 RxRisk score, mean (SD) 3210 (2990) 3470 (3700) .44 Charlson Comorbidity Index, n (%) 0 118 (81) 342 (78) 1 11 (8) 44 (10) .84 2 8 (5) 23 (5) ≥3 9 (6) 28 (6) Propensity score, mean (SD 0.29 (0.15) 0.29 (0.15) .84 Healthcare utilization Hospitalizations, mean (SD)† 0.31 (0.68) 0.26 (0.63) .44 One or more hospitalizations, n (%) 32 (22) 83 (19) .44 Medical/surgical specialist visits, mean (SD) 4.8 (7.5) 4.8 (6.3) .97 Outpatient visits, mean (SD) 18.7 (14.0) 18.3 (13.2) .74 Any nursing home admission, n (%) 11 (7.5) 29 (6.6) .71 Number of 14-day equivalent high-risk prescriptions, mean (SD)‡ 4.2 (11.2) 4.9 (15.6) .58 Total healthcare costs, median $§ 5068 4977 .72 * Block-level 2000 United States Census data as identified by geocoding techniques using subjects’ 2005 street addresses and ZIP codes. Education and non-white race status pertain to adults over age 25 years. Income and education data were missing for 89 subjects (15.3%), and non-white race data were missing for 105 subjects (18.0%).
† During year prior to index date.
‡ Includes selected sedative-hypnotics, antihistamines, muscle relaxants, and tricyclic antidepressants.
§ Pre-index date costs were missing/incomplete for 6 control subjects. P value derived from nonparametric χ2 test for difference in medians.
- Table 2.
Hospitalization Rates by Principal Discharge Diagnosis Before and After Index Date of Intervention
Discharge Diagnosis Prior to Index Date During Follow-up Crude Hospitalization Rate (per 100 person-years) Relative Rate Crude Hospitalization Rate (per 100 person-years) Relative Rate Intervention (N = 146) Controls (N = 437) Intervention (N = 146) Controls (N = 437) Gastrointestinal diseases* 2.7 2.2 1.2 3.6 6.1 0.6 Infection 3.4 2.7 1.3 2.6 4.9 0.5 Cardiovascular diseases Ischemic heart disease 2.7 3.0 0.9 1.6 3.3 0.5 Congestive heart failure 2.1 1.4 1.5 1.6 3.3 0.5 Stroke 1.4 2.1 0.7 1.0 1.0 1.0 Other circulatory diseases 4.1 3.0 1.4 2.6 2.6 1.0 Degenerative musculoskeletal diagnoses† 2.7 3.2 0.9 1.0 1.7 0.6 Fractures and injuries 0.7 1.4 0.5 0.5 2.4 0.2 Neoplasm 1.4 0.7 2.0 1.0 1.7 0.6 Chronic obstructive pulmonary disease or respiratory failure 1.4 1.4 1.0 0.5 1.9 0.3 Other diagnoses‡ 8.2 5.0 1.6 4.2 6.8 0.6 Total 30.8 26.1 1.18 20.3 35.2 0.58 * Includes International Classification of Disease, 9th Edition, Clinical Modification (ICD-9-CM) codes 520–579.
† Principally osteoarthroses.
‡ Includes fluid/electrolyte/metabolic disorders, syncope and collapse, renal failure, dementia or delirium, ear diseases, genital prolapse, nonspecific signs or symptoms, unspecified complications of medical or surgical care (ICD-9-CM 996–999), and anemia.
- Table 3.
Utilization Outcomes and Mortality Following Index Date among Subjects Receiving Geriatric Intervention and Sex and Propensity-Matched Controls*
Outcome Crude Rate (per 100 Person-Years) Rate Ratios (95% Confidence Interval) Intervention (N = 146) Control (N = 437) Crude Conditional on Propensity Score Conditional with Adjustment† Medical/surgical specialty visits 355 425 0.83 (0.76, 0.91) 0.93 (0.77, 1.12) 0.95 (0.79, 1.15) Outpatient visits 1590 1620 0.98 (0.94, 1.02) 1.01 (0.90, 1.13) 1.03 (0.92, 1.15) Admission to nursing home 8.3 7.6 1.1 (0.6, 2.0) 1.1 (0.6, 1.9) 0.92 (0.48, 1.78) Mortality 6.2 6.1 1.0 (0.5, 2.0) 1.0 (0.5, 2.0) 1.12 (0.52, 2.40) 14-day prescription of high-risk medication 142 267 0.53 (0.47, 0.61) 0.73 (0.49, 1.09) 0.76 (0.50, 1.14) * Intervention and control were matched by a propensity score, which was derived to account for demographic, clinical, and utilization factors that predicted selection for the intervention.
† Adjusted for age (linear and quadratic), heart disease, and dementia and/or Parkinson’s disease.
