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Consequences of Preventing Delirium in Hospitalized Older Adults on Nursing Home Costs
Author(s) -
Leslie Douglas L.,
Zhang Ying,
Bogardus Sidney T.,
Holford Theodore R.,
LeoSummers Linda S.,
Inouye Sharon K.
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53156.x
Subject(s) - medicine , delirium , randomized controlled trial , long term care , nursing homes , intervention (counseling) , emergency medicine , pediatrics , intensive care medicine , nursing
Objectives: To determine whether costs of long‐term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention. Design: Longitudinal follow‐up from a randomized trial. Setting: Posthospital discharge settings: community‐based care and NHs. Participants: Eight hundred one hospitalized patients aged 70 and older. Measurements: Patients were followed for 1 year after discharge, and measures of NH service use and costs were constructed. Total long‐term NH costs were estimated using a two‐part regression model and compared across intervention and control groups. Results: Of the 400 patients in the intervention group and 401 patients in the matched control group, 153 (38%) and 148 (37%), respectively, were admitted to a NH during the year, and 54 (13%) and 51 (13%), respectively, were long‐term NH patients. The MTI had no effect on the likelihood of receiving long‐term NH care, but of patients receiving long‐term NH care, those in the MTI group had significantly lower total costs, shorter length of stay and lower cost per survival day. Adjusted total costs were $50,881 per long‐term NH patient in the MTI group and $60,327 in the control group, a savings of 15.7% ( P =.01). Conclusion: Active methods to prevent delirium are associated with a 15.7% decrease in long‐term NH costs. Shorter length of stay of patients receiving long‐term NH services was the primary source of these savings.