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Medical Care Research and Review
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Determinants of Cost among People Who Died in VA Nursing Homes

Wei Yu

Todd H. Wagner

Paul G. Barnett

VA Health Economics Resource Center and Stanford University

We examined final stays of elderly patients (65 or more years of age) who died in 111 VA nursing homes in fiscal year 2000 (N = 4,897) to evaluate determinants of the cost of final nursing home stays. We analyzed cost and its two main components (length of stay and intensity of care) by primary disease, age, race or ethnicity, gender, and benefit-eligibility type. We found that disease rather than age was the dominant factor influencing the cost of final nursing home stays. After controlling for six common diagnoses, age was not associated with cost. Marital status and race or ethnicity were also significant predictors but accounted for less variation than illnesses. Incorporating illness into models that predict future demand for nursing home use provides greater precision than using age alone, especially as diseases and their treatments change through time.

Key Words: nursing home cost • end of life • aging • veterans

Medical Care Research and Review, Vol. 63, No. 4, 477-498 (2006)
DOI: 10.1177/1077558706288843
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