Long-term care benefits may reduce end-of-life medical care costs

Published: December 1, 2014
Category: Bibliography > Papers
Authors: Center BA, Evered SR, Holland SK
Countries: United States
Language: null
Types: Population Health
Settings: Health Plan, PCP

Popul Health Manag

Univita , Natick, MA, USA

This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by a long-term care (LTC) insurance policy can reduce health care utilization and costs at the end of life. This retrospective study uses propensity score matching methodology, hierarchical multiple regression, and Poisson regression to compare 830 decedents who utilized benefits from a voluntary LTC insurance plan (“claimants”) to 6860 decedents who never purchased coverage but were similar to claimants on 17 variables, including age, sex, frailty, burden of illness markers, and propensity to have needed LTC services. Claimants using LTC benefits experienced significantly lower health care costs at end of life, including 14% lower total medical costs, 13% lower pharmacy costs, 35% lower inpatient admission costs, and 16% lower outpatient visit costs. They also experienced 8% fewer inpatient admissions and 10% fewer inpatient days. The presence of dementia at the end of life moderated these effects. This study suggests that use of insurance-based LTC services measurably reduces health care expenditures at the end of life.

PMID: 24784144

United States,Cost Burden Evaluation,High-Impact Chronic Conditions,Age,80 and over,Cognition Disorders/therapy,Cost Control,Gender,Health Services/economics,Poisson Distribution,Propensity Score,Retrospective Studies,Terminal Care/utilization

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