Cost trajectories as a measure of functional resilience after hospitalization in older adults

BACKGROUND: Administrative datasets lack functional measures. AIMS: We examined whether trajectories of cost can be used as a marker of functional recovery after hospitalization. METHODS: Secondary analysis of the National Health and Aging Trends Study merged with Centers for Medicare and Medicaid Services data. Community-dwelling participants with a first hospitalization occurring after any annual survey were included (N=937). Monthly total cost trajectories were constructed for the 3 months before and 3 months following hospitalization. Growth mixture models identified groups of patients with similar trajectories. The association of cost classes with 5 functional outcomes was examined using multivariate models, controlling for pre-hospitalization function and lead time. RESULTS: Four cost trajectory classes describing common recovery patterns were identified – persistently high, persistently moderate, low-spike-recover, and low variable. Cost class membership was significantly associated with change in Activities of Daily Living (ADL), instrumental ADL, Short Physical Performance Battery, and grip strength (p