The relationship between physician cost and functional status in the elderly.
OBJECTIVE
To explore the relationship between functional status and physician cost (general practitioner/specialist) in an elderly population.


METHODS
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.


METHODS
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.
Pollicino
C A
CA
Department of General Practice, University of Sydney, Australia.
Saltman
D C
DC
D000203:Activities of Daily Living / Q000145:classification*; D000359:Aftercare / Q000191:economics; D000368:Aged; D003365:Costs and Cost Analysis; D004470:Economics, Medical; D005194:Family Practice / Q000191:economics; D005251:Fees, Medical / Q000145:classification* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006305:Health Status Indicators; D006786:Hospitals, Urban / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D010820:Physicians / Q000145:classification / Q000191:economics*; D012044:Regression Analysis; D013038:Specialization