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Intensive procedures for inpatient Medicare patients jump

Case Management Weekly, April 14, 2004

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Inpatient treatment intensity for all Medicare fee-for-service beneficiaries increased between 1985 and 1999, regardless of survivorship status, a study revealed earlier this month. Those undergoing one or more intensive procedures increased from 20.9% to 31% among decedents and from 5.8% to 8.5% among survivors, according to new research released April 1 from Amber E. Barnato, M.D., MPH, MS, assistant professor of medicine and health policy and management at the University of Pittsburgh. In 1999, 50% of feeding tube placements, 60% of intubations/tracheostomies, and 75% of cardiopulmonary resuscitations were in decedents. The proportion of beneficiaries dying in a hospital decreased from 44.4% to 39.3%, but the likelihood of being admitted to an intensive care unit or undergoing an intensive procedure during the terminal hospitalization increased from 38.0% to 39.8% and from 17.8 percent to 30.3%, respectively, Barnato found. One in five Medicare beneficiaries who died in the hospital in 1999 received mechanical ventilation during their terminal admission.

For more data and information on this topic, including hospice related data and charts, subscribe to Case Management Training Monthly. A full report on this study will come with your subscription by June 2004. Go to www.hcmarketplace.com for details.

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