Observational studyAnnals of internal medicine2019
Medicare Spending and the Adequacy of Support With Daily Activities in Community-Living Older Adults With Disability: An Observational Study.
Observational study in Annals of internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 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
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- International depiction of the cost of functional independence limitations among older adults living in the community: a systematic review and cost-of-impairment study.BMC geriatrics · 2022Pooled it
- Design Preferences for Mental Health Apps Among Nondigitally Native Adults With Chronic Pain: Qualitative Analysis.JMIR mHealth and uHealth · 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
- Medicaid funds direct care for one in four dual-eligible older adults nationally, but state variation is 4-fold.Health affairs scholar · 2026Article
- Effects of Dual-Eligible Integrated Care Plans on Medicaid Enrollment and Retention: Evidence From the Implementation of Medicare-Medicaid Plans.Medical care research and review : MCRR · 2026Article
- Evaluating and Optimizing Just-in-Time Adaptive Interventions in a Digital Mental Health Intervention (Wysa for Chronic Pain) for Middle-Aged and Older Adults With Chronic Pain: Protocol for a Series of Randomized Trials.JMIR research protocols · 2025Article
- Late-life disability may increase with more frequent insomnia symptoms and sleep medications use over time.Sleep · 2025Article
- Informal Care Receiving Among Older Adults: The Role of Multimorbidity and Intersectional Social Position.The Gerontologist · 2025Article
- Patient-Reported Characteristics Across Dual-Eligible Medicare Advantage Plan Types.JAMA network open · 2025Article
- Paying for home care out-of-pocket is common and costly across the income spectrum among older adults.Health affairs scholar · 2025Article
- Outcomes After Community Discharge From Skilled Nursing Facilities: The Role of Medicaid Home and Community-Based Services.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
- Changes in Care Associated With Integrating Medicare and Medicaid for Dual-Eligible Individuals.JAMA health forum · 2023Article
- The Role of Place in Person- and Family-Oriented Long-Term Services and Supports.The Milbank quarterly · 2023Article
- The Home Care Workforce Has Not Kept Pace With Growth In Home And Community-Based Services.Health affairs (Project Hope) · 2023Article
- Associations Between Use of Paid Help and Care Experiences Among Medicare-Medicaid Enrolled Older Adults With and Without Dementia.The journals of gerontology. Series B, Psychological sciences and social sciences · 2022Article
- Sensory Impairment and the Odds of Adverse Consequences of Unmet Needs for Care Among Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2022Article
- Unmet family caregiver training needs associated with acute care utilization during home health care.Journal of the American Geriatrics Society · 2021Article
- Receipt of Posthospitalization Care Training Among Medicare Beneficiaries' Family Caregivers.JAMA network open · 2021Article
- Patient-Reported Social and Behavioral Determinants of Health and Estimated Risk of Hospitalization in High-Risk Veterans Affairs Patients.JAMA network open · 2020Article
- Social Vulnerability and Medical Complexity Among Medicare Beneficiaries Receiving Home Health Without Prior Hospitalization.Innovation in aging · 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
6 authors at 1 institution in 1 country.
Funding
Abstract
Background: Identifying factors that affect variation in health care spending among older adults with disability may reveal opportunities to better address their care needs while offsetting excess spending. Objective: To quantify differences in total Medicare spending among older adults with disability by whether they experience negative consequences due to inadequate support with household activities, mobility, or self-care. Design: Observational study of in-person interviews and linked Medicare claims. Setting: United States, 2015. Participants: 3716 community-living older adults who participated in the 2015 NHATS (National Health and Aging Trends Study) and survived for 12 months. Measurements: Total Medicare spending by spending quartile in multivariable regression models that adjusted for individual characteristics. Results: Negative consequences were experienced by 18.3% of participants with disability in household activities, 25.6% with mobility disability, and 20.0% with self-care disability. Median Medicare spending was higher for those who experienced negative consequences due to household ($4866 vs. $4095), mobility ($7266 vs. $4115), and self-care ($10 935 vs. $4436) disability versus those who did not. In regression-adjusted analyses, median spending did not differ appreciably for participants who experienced negative consequences in household activities ($338 [95% CI, -$768 to $1444]), but was higher for those with mobility ($2309 [CI, $208 to $4409]) and self-care ($3187 [CI, $432 to $5942]) disability. In the bottom-spending quartile, differences were observed for self-care only ($1460 [CI, $358 to $2561]). No differences were observed in the top quartile. Limitation: This observational study could not establish causality. Conclusion: Inadequate support for mobility and self-care is associated with higher Medicare spending, especially in the middle and lower ends of the spending distribution. Better support for the care needs of older adults with disability could offset some Medicare spending. Primary Funding Source: The Commonwealth Fund.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.