Researchers are documenting substantial reductions in Medicare hospitalizations, mortality and costs over a fifteen year period, based on a review of 68 million admissions of fee-for-service Medicare patients across the United States.
For 2013 compared to 1999, hospitalizations were found to have fallen by 24 percent and costs were judged to have fallen by 15 percent. And risk of inpatient death during the same period fell by 45 percent, according to researchers.
Lead researcher Harlan M. Krumholz, MD, SM, a cardiologist and professor at the Yale University School of Medicine, told USA Today that the reported 16 percent decline in Medicare mortality is “a jaw dropping finding. We didn’t expect to see such a remarkable improvement over time.”
Authors cite five possible factors influencing cost reductions and improved outcomes. These include: (1) the 1992 Health Care Quality Improvement Initiative, in which Quality Improvement Organizations were asked to work with hospitals to focus on collaborative quality improvement rather than inspections of care; (2) adoption of healthier behaviors by Americans over the fifteen year period; (3) public health advances that tend to benefit patients born in later years; (4) better procedures, technologies, devices and drugs; and (5) the possibility that patients in Medicare Advantage plans are sicker than fee-for-service patients, thus leading to an over-estimation of the gains for all Medicare patients.
The authors say their findings were consistent across ages, sexes and races. They also found sharp declines in hospitalizations in the last six months of life (28%), and the percentage of beneficiaries with one or more hospitalizations (14%).
The article “Mortality, Hospitalizations, and Expenditures for the Medicare Population Aged 65 Years or Older, 1999-2013,” appears in the Journal of the American Medical Association, July 28, 2015. To obtain a copy of the article, visit the JAMA website.
Please note: To access the article in it’s entirety, you must be a JAMA subscriber and/or purchase the article. The link to the abstract is included above.
For information on our efforts to improve care coordination and reduce avoidable hospital readmissions, visit our Web site and join the Great Plains Quality Innovation Network Learning and Action Network to get involved.