An analysis of the costs of treating aged patients in a large clinical hospital in Poland under the pressure of recent demographic trends.

Abstract

IntroductionThe aging of modern societies increases the general healthcare burden due to the growing demand for inpatient services, which lack adequate financing.Material and methodsData concerning the costs of 312,250 hospitalizations at University Clinical Hospital in Wrocław, Poland in the years 2012–2015 were analyzed according to the age of the patients: below 65 years and 65 years and older, with subgroups (65–74, 75–84 and 85 years and older).ResultsThe mean length of stay (LOS) differed significantly for patients below 65 years and for patients 65 years old or older (3.5 vs. 4.7 person-days); over the 4 years covered by our data, these increased by 0.4 person-days, mostly among patients 85 years and older (by 0.7 person-days). The mean direct cost of hospitalization differed significantly for patients below 65 years and those 65 years or older (PLN 4,907.12 vs. PLN 6,357.15). The mean cost of laboratory tests and radiologic diagnostics was significantly higher among those in the 65+ group, and the difference had a rising trend. The differences between age groups in cost-related hospitalization characteristics and direct hospitalization costs that have been suggested by the medical literature have also been confirmed in Poland.ConclusionsThe mean hospitalization costs of patients aged 65 years and older in Poland are higher than for younger patients due to longer LOS and more complex and expensive treatment, especially laboratory and radiologic diagnostics, which is increasingly common in the oldest age groups. This demands an urgent systemic solution, especially in terms of adjusted financing of elderly patients’ hospital treatment.