Sensitivity of Nursing Home Cost Comparisons to Method of Dementia Diagnosis Ascertainment

Table 4

Dementia versus nondementia cost ratios for different Medicare cost categories by method of ascertainment.

Adjusted cost ratios PPM (95%confidenceintervals)^a: dementia versus non-dementia
	Overall	SNF	Inpatient Hospital	Physician	Other services^b
Panel	0.65 (0.52, 0.80)	0.68 (0.43, 1.09)	0.75 (0.50, 1.12)	0.74 (0.63, 0.88)	0.52 (0.43, 0.62)
Chart	0.70 (0.58, 0.86)	0.65 (0.44, 0.98)	0.78 (0.56, 1.09)	0.82 (0.72, 0.93)	0.46 (0.36, 0.59)
Medicare	0.80 (0.67, 0.96)	0.69 (0.49, 0.99)	0.96 (0.71, 1.29)	0.85 (0.73, 1.00)	0.54 (0.45, 0.65)
Chart or Medicare	0.78 (0.66, 0.91)	0.64 (0.45, 0.90)	0.94 (0.74, 1.20)	0.86 (0.77, 0.97)	0.51 (0.43, 0.61)
Chart or Medicare or Panel	0.68 (0.57, 0.81)	0.61 (0.40, 0.95)	0.81 (0.60, 1.10)	0.78 (0.68, 0.90)	0.50 (0.43, 0.59)

^aCosts inflated to 1997 dollars, models from GEE assuming Gamma distribution. Costs are those incurred in the nursing home up to 24 months after admission and only include those periods in which the patient was in the initial nursing home. Cost ratios are adjusted for age, gender, race, marital status, ADL, chairfast, bedfast, DCG/HCC, Medicare qualified stay, and Medicaid status at admission. ^bOtherservices include outpatient, home health, durable medical equipment, and hospice costs.