Disaster impacts on cost and utilization of Medicare

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  • Rosenheim, Nathanael
    • Other Affiliation: Hazard Reduction and Recovery Center, 3137 TAMU, College Station, TX 77843, USA
  • Grabich, Shannon C
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Horney, Jennifer A
    • Other Affiliation: Department of Epidemiology and Biostatistics, Texas A&M University School of Public Health, 1266 TAMU, College Station, TX 77843, USA
Abstract
  • 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.
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  • Article
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  • In Copyright
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  • The Author(s).
Language
  • English
Bibliographic citation
  • BMC Health Services Research. 2018 Feb 07;18(1):89
Publisher
  • BioMed Central

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