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. 2010 Dec;91(12):1849-55.
doi: 10.1016/j.apmr.2010.08.010.

Estimating transition probabilities in mobility and total costs for medicare beneficiaries

Jeanne M Hoffman  1 , Marcia A Ciol, Minh Huynh, Leighton Chan
Affiliations

Estimating transition probabilities in mobility and total costs for medicare beneficiaries

Jeanne M Hoffman et al. Arch Phys Med Rehabil. 2010 Dec.

Abstract

Objective: To examine how persons move back and forth along levels of mobility disability.

Design: Self-reported mobility limitations were used to create categories of annual transition states. The total cost to Medicare associated with each year was calculated for each participant. In addition, we examined cost relative to transition state, adjusting for demographic and other health status variables.

Setting: National survey.

Participants: Participants in the longitudinal Medicare Current Beneficiary Survey from 1992 to 2005.

Interventions: Not applicable.

Main outcome measures: Annual self-reported mobility limitations and total Medi costs.

Results: Most participants remained without mobility limitations or improved over time. Reported average costs were 10 times higher for those who transitioned to severe limitations, unable to walk, or death compared with persons who reported no mobility limitation. Estimated costs were highest for those transitioning to increased states of disability and to death.

Conclusions: Mobility limitations in older adults are dynamic, and improvement (as measured by annual transitions) occurred for a large number of Medicare beneficiaries. High total annual costs were observed in groups that transitioned to worsening mobility states, suggesting a link between mobility limitation transitions and cost. Prevention and treatment of mobility limitation may be an important factor to consider in health care reform.

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Figures

Fig 1
Fig 1
Probability of remaining in the no-mobility limitation state by age and sex (A), education level (B), and income level (C). Abbreviations: HS, high school; SES, socioeconomic status; 25K, $25,000.
See this image and copyright information in PMC

References

    1. Choi N, Schlichting-Ray L. Predictors of transitions in disease and disability in pre- and early-retirement populations. J Aging Health. 2001;13:379–409. - PubMed
    1. Gill T, Allore H, Hardy S, Guo Z. The dynamic nature of mobility disability in older persons. J Am Geriatr Soc. 2006;54:248–54. - PubMed
    1. Gill T, Gahbauer E, Allore H, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166:418–23. - PubMed
    1. Masala C, Petretto D. From disablement to enablement: conceptual models of disability in the 20th century. Disabil Rehabil. 2008;30:1233–44. - PubMed
    1. Chan L, Doctor J, MacLehose R, et al. Do Medicare patients with disabilities receive preventive services? A population-based study. Arch Phys Med Rehabil. 1999;80:642–6. - PubMed

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