Medicare hospital-related mortality down since 1999




Several measures of mortality declined among hospitalized Medicare fee-for-service beneficiaries from 1999 to 2013, according to a study published July 28 in JAMA.

Over that time period, in-hospital mortality declined from 1.3% to 0.71%. Meanwhile, 30-day mortality declined from 2.16% in 1999 to 1.65% in 2013 and 1-year mortality slipped from 4.49% to 3.48% among 60,056,069 individuals aged 65 years or older who were enrolled in a Medicare fee-for-service plan for at least 1 month over the study period, reported Dr. Harlan M. Krumholz of Yale University in New Haven, Conn., and his associates.

The decline in mortality was accompanied by a drop in the number of hospitalizations, which went from more than 35,000/100,000 person-years of enrollment in 1999 to just under 27,000 in 2013. The number of beneficiaries admitted to the hospital at least once went down as well, from almost 22,000/100,000 person-years to more than 17,000, as did the number of hospitalizations that involved major surgery: 3,784/100,000 person-years in 1999 and 3,105 in 2013, the investigators noted (JAMA 2015;314:355-65).

For each of these measures, “the findings did not change substantially after accounting for beneficiaries’ demographic characteristics and geographical differences,” they wrote.

Dr. Krumholz is supported by a grant from the National Heart, Lung, and Blood Institute.

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