The relationship between physician cost and functional status in the elderly

Abstract

Objective. To explore the relationship between functional status and physician cost (general practitioner/specialist) in an elderly population. Design, setting and participants. A longitudinal study involving 328 patients aged 65 years or over admitted to medical and surgical wards of a Sydney metropolitan hospital over a 10-month period. Main outcome measures. Two predictive cost models were developed using multiple linear regression analyses. Nine predictors were modelled including functional status (Short Form 36; SF-36) and major diagnostic categories. These models were then applied to the Australian SF-36 norms to produce a profile of cost by level of functioning. Results. After adjusting for potential confounders, five variables were found to be predictive of general practitioner Cost at a 5% significance level. Females and age were positively associated, whereas case note mention of post-discharge services and high SF-36 vitality and role emotional scores were negatively predictive. For Specialist cost, five variables were statistically significant. The SF-36 domains of physical functioning and mental health Were positively associated. Higher vitality, role emotional scores and case note mention of post-discharge services were negatively associated. Conclusions. Cost models can be used to highlight the differences between general practitioner and specialist attendances, guide future physician care of the aged, and facilitate informed decision making.