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Author List:
Yu W (VA Health Economics Resource Center)
Ravelo A (Allergan Inc)
Wagner TH (VA Health Economics Resource Center)
Barnett PG (VA Health Economics Resource Center)
Objectives:
The number of veterans 85 or more years old increases at 11 percent per year from 1990 through 2010. We analyzed the relationships among age, chronic conditions, and healthcare costs in the Veterans Healthcare System.
Methods:
We used utilization data to find which, if any, of 29 common chronic diseases each elderly VA patient suffered. We classified patients by their most expensive chronic disease. We studied elderly patients treated in fiscal year 2000 (n=1,596,789): the young old (65 to 79 years of age) and the oldest old (80 years and over). We found annual healthcare costs for four categories of inpatient care and two categories of outpatient care.
Results:
VA patients who had any of the 29 chronic conditions accounted for 85 percent of the study population and 96 percent of the total cost. The oldest old were more likely to have expensive conditions. Compared to the young old, the oldest old had higher costs for long-term care for all 29 conditions, but higher overall cost for only 14 conditions.
Implications:
The prevalence of chronic conditions that require substantial long-term care among the oldest old veterans is the driving factor of the cost increase. Programs targeted to prevent or cure those age-dependent diseases that demand the most long-term care should be a high priority for VA healthcare managers.
Impacts:
Meeting the potential demand when the baby-boomer generation reaches very old age will inevitably require significant reform in our healthcare system, especially in the financing structure for long-term care.
