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Disaster impacts on cost and utilization of Medicare
- Source :
- BMC Health Services Research, BMC Health Services Research, Vol 18, Iss 1, Pp 1-9 (2018)
- Publication Year :
- 2018
- Publisher :
- BioMed Central, 2018.
-
Abstract
- Background To estimate changes in the cost and utilization of Medicare among beneficiaries over age 65 who have been impacted by a natural disaster, we merged publically available county-level Medicare claims for the years 2008–2012 with Federal Emergency Management Agency (FEMA) data related to disasters in each U.S. County from 2007 to 2012. Methods Fixed-effects generalized linear models were used to calculate change in per capita costs standardized by region and utilization per 1000 beneficiaries at the county level. Aggregate county demographic characteristics of Medicare participants were included as predictors of change in county-level utilization and cost. FEMA data was used to determine counties that experienced no, some, high, and extreme hazard exposure. FEMA data was merged with claims data to create a balanced panel dataset from 2008 to 2012. Results In general, both cost and utilization of Medicare services were higher in counties with more hazard exposure. However, utilization of home health services was lower in counties with more hazard exposure. Conclusions Additional research using individual-level data is needed to address limitations and determine the impacts of the substitution of services (e.g., inpatient rehabilitation for home health) that may be occurring in disaster affected areas during the post-disaster period.
- Subjects :
- Male
Health Services for the Aged
Frail Elderly
Administrative data
Poison control
Eligibility Determination
030204 cardiovascular system & hematology
Determinants of health
Medicare
Occupational safety and health
Health administration
Disasters
03 medical and health sciences
Access / demand / utilization
Insurance Claim Review
0302 clinical medicine
Environmental health
Per capita
Medicine
Humans
030212 general & internal medicine
Social determinants of health
Natural disaster
Aged
Emergency management
business.industry
Aging / older adults
Health Policy
lcsh:Public aspects of medicine
lcsh:RA1-1270
Hazard
United States
Female
Health Services Research
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....e3d40c76be4c63d2cb76b3590d060d0f