Further, the average cost for a hospitalized fee-for-service Medicare patient dropped from $3,290 to $2,801.
Advertisement
Medicare, the health insurance program for Americans aged 65 and older, is turning 50 this week.
Harlan M. Krumholz, M.D., S.M., of the Yale University School of Medicine, New Haven, Conn., and colleagues examined national trends between 1999 and 2013 in all-cause mortality for all Medicare beneficiaries and trends in all-cause hospitalization and hospitalization-associated outcomes and expenditures for fee-for-service beneficiaries. The percentage of beneficiaries with 1 or more hospitalizations decreased from 70.5 to 57 per 100 deaths, while the inflation-adjusted inpatient expenditure per death increased from $15,312 in 1999 to $17,423 in 2009 and then decreased to $13,388 in 2013.
The team found that annual mortality rates from all causes across the Medicare population declined from 5.3% in 1999 to 4.5% in 2013.
“We were amazed though, when we did a comprehensive study of what has been achieved, to see the size and scope of the improvements”, he said. This data, however, was not available for patients in Medicare’s managed-care portion – this section had close to 30 percent of all Medicare patients in 2013.
“There has been tremendous focus on making sure that our hospitals are safer and that treatments are more timely and effective”, Krumholz told USA Today.
Krumholz said these improvements are probably driven by several important trends.
“Even though it is hard to disentangle the specific reasons for improvement, it is clear that over the past 15 years there have been marked reductions in mortality, hospitalization, and adverse hospital outcomes among the Medicare population aged 65 years or older”, the authors write.
Hospitals and their staffs get some of the credit.
The amount of people hospitalized over that time period fell by 23%. “That was one of the first shots fired in the patient safety movement”, said Brennan, who was not involved in the new study.
“It is impossible to know what is most responsible for the improvement and it is likely to be many factors”, Krumholz said. New drugs for common conditions such as cancer and heart disease also may have kept people alive longer. “I am certain that our sophistication in improving health and health care, our investment in it, our determination to improve has made the difference”.
Burstin said she hopes the country will expand its efforts to improve health care quality by focusing on outpatient care, such as that given in nursing homes or by home health aides.
While these results are encouraging, they should not lead to complacency, the researchers caution.
Advertisement
“The things we’re trying to do to make things better are working”, Krumholz said.
