ArticleJournal of the American Geriatrics Society2017
Functional Impairment: An Unmeasured Marker of Medicare Costs for Postacute Care of Older Adults.
Article in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cross-sectional and prospective association between personality traits and IADL/ADL limitations.Psychology and aging · 2021Pooled it
- Feasibility and Preliminary Efficacy of a Multimodal Approach to Increase Physical Activity in Older Adults With Memory Complaints: The Education for Action Study.Journal of aging and physical activity · 2022Trial
- Statin use and functional response to multicomponent exercise in acutely hospitalized older adults: secondary analysis of a randomized trial.European geriatric medicine · 2026Article
- Discordance Between Self-Report and Performance-Based Measures Among At-Risk Older Adults: A Secondary Data Analysis.The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2026Article
- Socioeconomic status and the relationship of physical performance with activities of daily living among US older adults.PloS one · 2026Article
- Decomposing Medicare total, Part D, and Part B drug payments among people with Alzheimer's disease and related diseases.Health affairs scholar · 2025Article
- Recovery from disability after geriatric-home rehabilitation versus standard of care: protocol for a pilot study in older persons with disability at hospital discharge.Pilot and feasibility studies · 2025Article
- Functional Impairments, Phenotypic Frailty, and Sector-Specific Incremental Healthcare Costs in Older Adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults : A Prospective Cohort Study.Annals of internal medicine · 2023Article
- Temporal Trends (from 2008 to 2017) in Functional Limitations and Limitations in Activities of Daily Living: Findings from a Nationally Representative Sample of 5.4 Million Older Americans.International journal of environmental research and public health · 2023Article
- Association of Function, Symptoms, and Social Support Reported in Standardized Outpatient Clinic Questionnaires With Subsequent Hospital Discharge Disposition and 30-Day Readmissions.Archives of physical medicine and rehabilitation · 2022Article
- Life-space mobility and healthcare costs and utilization in older men.Journal of the American Geriatrics Society · 2021Article
- National profile of the growing population of older adults who access community health centers.Journal of the American Geriatrics Society · 2021Article
- Identification of Functional Limitations and Discharge Destination in Patients With COVID-19.Archives of physical medicine and rehabilitation · 2021Article
- Determinants of participation in a post-hospitalization physical exercise program for older adults.BMC geriatrics · 2020Article
- Physical Rehabilitation Needs in the BRICS Nations from 1990 to 2017: Cross-National Analyses Using Data from the Global Burden of Disease Study.International journal of environmental research and public health · 2020Article
- Getting Back to Normal: A Grounded Theory Study of Function in Post-hospitalized Older Adults.The Gerontologist · 2020Article
- A Platform and Clinical Model to Enable Medicare's Chronic Care Management Program.Population health management · 2020Article
- Potentially burdensome end-of-life transitions among nursing home residents with poor-prognosis cancer.Cancer · 2020Article
- Out-of-Pocket Healthcare Expenditures in Dependent Older Adults: Results From an Economic Evaluation Study in Mexico.Frontiers in public health · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectivesTo assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge.
designLongitudinal cohort study.
settingHealth and Retirement Study (HRS).
participantsNationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS: The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data. The main predictor was functional impairment (level of difficulty or dependence in activities of daily living (ADLs)), determined from HRS interview preceding hospitalization. Multivariable linear regression was performed, adjusted for age, race, sex, income, net worth, and comorbidities, with clustering at the individual level to characterize the association between functional impairment and costs of postacute care.
resultsUnadjusted mean Medicare costs for 1 year after discharge increased with severity of impairment in a dose-response fashion (P < .001 for trend); 68% had no functional impairment ($25,931), 17% had difficulty with one ADL ($32,501), 7% had dependency in one ADL ($39,928), and 8% had dependency in two or more ADLs ($45,895). The most severely impaired participants cost 77% more than those with no impairment; adjusted analyses showed attenuated effect size (33% more) but no change in trend. Considering costs attributable to comorbidities, only three conditions were more expensive than severe functional impairment (lymphoma, metastatic cancer, paralysis).
conclusionFunctional impairment is associated with greater Medicare costs for postacute care and may be an unmeasured but important marker of long-term costs that cuts across conditions.
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