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dc.creatorHamel, Mary Bethen
dc.creatorPhillips, Russell S.en
dc.creatorTeno, Joan M.en
dc.creatorLynn, Joanneen
dc.creatorGalanos, Anthony N.en
dc.creatorDavis, Roger B.en
dc.creatorConnors, Alfred F.en
dc.creatorOye, Robert K.en
dc.creatorDesbiens, Normanen
dc.creatorReding, Douglas J.en
dc.creatorGoldman, Leeen
dc.date.accessioned2015-05-05T18:59:18Zen
dc.date.available2015-05-05T18:59:18Zen
dc.date.created1996-09en
dc.date.issued1996-09en
dc.identifier10.1111/jgs.1996.44.issue-9en
dc.identifier.bibliographicCitationJournal of the American Geriatrics Society. 1996 Sep; 44(9): 1043-1048.en
dc.identifier.issn0002-8614en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Seriously+Ill+Hospitalized+Adults:+Do+We+Spend+Less+on+Older+patients?+&title=Journal+of+the+American+Geriatrics+Society.++&volume=44&issue=9&pages=1043-1048&date=1996&au=Hamel,+Mary+Bethen
dc.identifier.urihttp://dx.doi.org/10.1111/jgs.1996.44.issue-9en
dc.identifier.urihttp://hdl.handle.net/10822/750736en
dc.description.abstractOBJECTIVE: To determine the effect of age on hospital resource use for seriously ill adults, and to explore whether age-related differences in resource use are explained by patients' severity of illness and preferences for life-extending care. STUDY DESIGN: Prospective cohort study. SETTING: Five geographically diverse academic acute care medical centers participating in the SUPPORT Project. PATIENTS: A total of 4301 hospitalized adults with at least one of nine serious illnesses associated with an average 6-month mortality of 50%. MEASUREMENTS: Resource utilization was measured using a modified version of the Therapeutic Intervention Scoring System (TISS); the performance of three invasive procedures (major surgery, dialysis, and right heart catheter placement); and estimated hospital costs. RESULTS: The median patient age was 65; 43% were female, and 48% died within 6 months. After adjustment for severity of illness, prior functional status, and study site, when compared with patients younger than 50, patients 80 years or older were less likely to undergo major surgery (adjusted odds ratio .46), dialysis (.19), and right heart catheter placement (.59) and had median TISS scores and estimated hospital costs that were 3.4 points and $ 71.61 lower, respectively. These differences persisted after further adjustment for patients' preferences for life-extending care. CONCLUSIONS: Compared with similar younger patients, seriously ill older patients receive fewer invasive procedures and hospital care that is less resource-intensive and less costly. This preferential allocation of hospital services to younger patients is not based on differences in patients' severity of illness or general preferences for life-extending care.en
dc.formatArticleen
dc.languageenen
dc.sourceBRL:MEDKIE/96382364en
dc.subjectAdultsen
dc.subjectAge Factorsen
dc.subjectAgeden
dc.subjectAttitudesen
dc.subjectBiomedical Technologiesen
dc.subjectCritically Illen
dc.subjectEconomicsen
dc.subjectEvaluationen
dc.subjectEvaluation Studiesen
dc.subjectHealthen
dc.subjectHealth Careen
dc.subjectHeartsen
dc.subjectHospitalsen
dc.subjectIllnessen
dc.subjectLifeen
dc.subjectMortalityen
dc.subjectPatient Careen
dc.subjectPatientsen
dc.subjectProlongation of Lifeen
dc.subjectRenal Dialysisen
dc.subjectResource Allocationen
dc.subjectResuscitationen
dc.subjectSelection for Treatmenten
dc.subjectSurgeryen
dc.titleSeriously Ill Hospitalized Adults: Do We Spend Less on Older Patients?en
dc.provenanceDigital citation created by the National Reference Center for Bioethics Literature at Georgetown University for the BIOETHICSLINE database, part of the Kennedy Institute of Ethics' Bioethics Information Retrieval Project funded by the United States National Library of Medicine.en
dc.provenanceDigital citation migrated from OpenText LiveLink Discovery Server database named NBIO hosted by the Bioethics Research Library to the DSpace collection BioethicsLine hosted by Georgetown University.en


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