Survival of adult high-cost patients. Report of a follow-up study from nine acute-care hospitals
S. A. Schroeder, J. A. Showstack and J. Schwartz
To assess the degree to which high-cost illness is terminal illness,
survival data were obtained on a random sample of 776 adult high-cost
patients from nine acute-care hospitals in the San Francisco Bay area. Two
years after discharge, at least 34% of high-cost patients had died. These
patients accounted for 39% of the hospital charges incurred by the total
group of patients studied. Among the factors significantly associated with
death were a diagnosis of cancer (62% death), age older than 64 years (44%
death), discharge from a medical (as opposed to surgical) service (42%
death), and hospital bill of $10,000 and more (48% death). In-hospital and
posthospital death rates varied greatly among the nine hospitals. The data
suggest that large amounts of medical care are consumed by patients with
unfavorable prognoses.
