title: Nursing home characteristics related to medicare costs for residents with and without dementia.
abstract: OBJECTIVE
  To evaluate the relationship of nursing home characteristics to Medicare costs overall and by dementia status.
  
  
  METHODS
  New admissions followed for 2 years. Setting. Random stratified sample of 55 Maryland nursing homes.
  
  
  METHODS
  Sample of 1257 residents.
  
  
  METHODS
  Records, interview, and observation.
  
  
  RESULTS
  Medicare costs were lower in facilities that have a better environmental quality, hospice beds, and more food service workers; costs were higher in hospital-based facilities and those that have a higher Medicaid case mix, X-ray, and some specified types of staff. Across all characteristics, costs for residents with dementia were consistently two-thirds the cost of other residents.
  
  
  CONCLUSIONS
  In terms of dementia status, resident characteristics drive Medicare costs, as opposed to facility characteristics. Using alternative residential settings for individuals with dementia may increase Medicare costs of nursing home residents and Medicare costs of residents with dementia who are cared for in settings less able to attend to medical needs.
authors.affiliation: Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research and the School of Social Work, University of North Carolina at Chapel Hill, North Carolina 27514, USA. Sheryl_Zimmerman@unc.edu
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.forename: Ann L
authors.initials: AL
authors.lastname: Gruber-Baldini
authors.forename: J Richard
authors.initials: JR
authors.lastname: Hebel
authors.forename: Lynda
authors.initials: L
authors.lastname: Burton
authors.forename: Kenneth
authors.initials: K
authors.lastname: Boockvar
authors.forename: George
authors.initials: G
authors.lastname: Taler
authors.forename: Charlene C
authors.initials: CC
authors.lastname: Quinn
authors.forename: Jay
authors.initials: J
authors.lastname: Magaziner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D003704:Dementia / Q000191:economics* / Q000451:nursing; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008396:Maryland; D006278:Medicare / Q000191:economics*; D009735:Nursing Homes / Q000191:economics* / Q000458:organization & administration; D011787:Quality of Health Care / Q000191:economics; D014481:United States; D000078329:Workforce