Abstract
BackgroundThe State of Louisiana spends the most on Medicare beneficiaries per capita, but reports greater disparities in health status and death rates than other states. This project sought to investigate the associations between healthcare intensity, healthcare spending, and mortality in Louisiana.MethodsWe used a 100% sample of 2014 Medicare claims data with beneficiaries assigned to hospital referral regions in Louisiana using small area analysis. We used simple and multivariable linear regression modelling to evaluate associations between healthcare intensity, healthcare spending rates, and mortality rates. We adjusted for age, sex, race, and population health risk factors.ResultsWe found no statistically significant associations between our measured variables when adjusted for age, sex, and race. These results were consistent after further adjusting mortality for population health risk factors.ConclusionsTo our knowledge, no prior studies have investigated the associations between healthcare intensity, healthcare spending, and mortality in Louisiana. Our findings suggest that increased healthcare spending in Louisiana may not improve survival. Identifying more granular aspects of healthcare contributing to spending patterns in Louisiana may provide targets for future quality improvement work.
Highlights
The State of Louisiana spends the most on Medicare beneficiaries per capita, but reports greater disparities in health status and death rates than other states
We investigated the associations between healthcare intensity, healthcare spending, and mortality in Louisianan Medicare beneficiaries
We found the prevalence of physical activity, obesity, and smoking for each hospital referral region in Louisiana by linking the Behavioral Risk Factor Surveillance System database with geographic boundaries provided by the Dartmouth Atlas Project
Summary
The State of Louisiana spends the most on Medicare beneficiaries per capita, but reports greater disparities in health status and death rates than other states. This project sought to investigate the associations between healthcare intensity, healthcare spending, and mortality in Louisiana. In the United States, there is a strong association between the intensity of inpatient care and healthcare spending in the Medicare population [10,11,12], but the association between spending and mortality remains elusive and highly contentious [1, 10, 13,14,15,16,17,18,19]
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