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Medicare Expenditure Per Patient Up for Acute MI

Increase in expenditure from 1998-1999 to 2008; ~75 percent of increase from days 31 to 365
TUESDAY, Sept. 24 (HealthDay News) -- For patients with acute myocardial infarction (AMI), Medicare expenditures per patient increased significantly from 1998-1999 to 2008, according to research published online Sept. 23 in JAMA Internal Medicine.
Donald S. Likosky, Ph.D., from the University of Michigan in Ann Arbor, and colleagues compared expenditures for a random 20 percent sample of fee-for-service Medicare beneficiaries admitted with AMI from 1998 through 1999 (105,074 patients) and a 100 percent sample for 2008 (212,329 patients).
The researchers observed a 19.2 percent decrease in the rate of AMI hospitalizations, but overall per-patient expenditures increased by 16.5 percent. About one-quarter (25.6 percent) of the total risk-adjusted increase in expenditures occurred within 30 days, and 74.4 percent occurred 31 to 365 days after the index admission. There were increases in spending per beneficiary within 30 days (7.5 percent increase; $1,560) and between 31 and 365 days (28 percent increase; $4,535). From 31 to 365 days after admission, the expenditures for skilled nursing facilities, hospice, home health agencies, durable medical equipment, and outpatient care almost doubled.
"Between 1998 and 2008, Medicare expenditures per patient with an AMI substantially increased, with about three-fourths of the increase in expenditures occurring 31 to 365 days after the date of hospital admission," the authors write.
Full Text (http://archinte.jamanetwork.com/article.aspx?articleid=1740698 )Editorial (http://archinte.jamanetwork.com/article.aspx?articleid=1740695 )
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