Statistics Show Deaths and Hospitalization Rates Among Older Patients On the

A comprehensive analysis of national hospital trends in the Medicare fee-for-service population can provide an assessment of past performance and targets for future interventions, according to background information in the article.

Among Medicare fee-for-service beneficiaries age 65 years or older, all-cause mortality and hospitalization rates, along with inpatient expenditures per beneficiary, decreased from 1999 to 2013, according to a study in the July 28 issue of JAMA, a theme issue on Medicare and Medicaid at 50.

“We are in the midst of a remarkable era of improvements in health and health care in America”, said lead author Harlan M. Krumholz, M.D., the Harold H.

A total of 68,374,904 Medicare beneficiaries – including 60,056,069 fee-for-service beneficiaries – made up the sample analyzed in the study.

Between 1999 and 2013, they discovered losses on any cause weakened among Medicare beneficiaries in question from 6.30 percentage in to some. This information wasn’t available for people in the managed care portion of Medicare, which had about 29% of patients in the overall Medicare program in 2013.

Krumholz said these improvements are probably driven by several important trends. The group was chosen for their “fee-for-service” structure, where doctors and hospitals would be paid per procedure or visit. Their chance of survival and recovery had improved from less than two decades ago: patients were 45% less likely to die during their stay, 24% less likely to die within a month of being admitted, and 22% less likely to die within the year. This is good news, because it means the treatments patients got at the hospitals were more effective and had fewer adverse events, like healthcare-associated infections.

“Nevertheless, this improvement occurred in a period of intense focus on improving health care delivery, the quality of care, and on promoting healthier behaviors and populations”, he added. “That was one of the first shots fired in the patient safety movement”, said Brennan, who was not involved in the new study.

“This decline represents millions of hospitalizations averted and hundreds of thousands of deaths delayed”, Krumholz said in an announcement. While more Americans today are obese than in the 1990s, the air is generally cleaner and fewer people smoke. By 2013, more people were discharged to skilled nursing facilities, long-term care, hospice, or home health services.

While these results are encouraging, they should not lead to complacency, the researchers caution.

“The things we’re trying to do to make things better are working”, Krumholz said. “There’s no reason to take our foot off the pedal”.