Consequences of preventing delirium in hospitalized older adults on nursing home costs

J Am Geriatr Soc. 2005 Mar;53(3):405-9. doi: 10.1111/j.1532-5415.2005.53156.x.


Objectives: To determine whether costs of long-term nursing home (NH) care for patients who received a multicomponent targeted intervention (MTI) to prevent delirium while hospitalized were less than for those who did not receive the intervention.

Design: Longitudinal follow-up from a randomized trial.

Setting: Posthospital discharge settings: community-based care and NHs.

Participants: Eight hundred one hospitalized patients aged 70 and older.

Measurements: Patients were followed for 1 year after discharge, and measures of NH service use and costs were constructed. Total long-term NH costs were estimated using a two-part regression model and compared across intervention and control groups.

Results: Of the 400 patients in the intervention group and 401 patients in the matched control group, 153 (38%) and 148 (37%), respectively, were admitted to a NH during the year, and 54 (13%) and 51 (13%), respectively, were long-term NH patients. The MTI had no effect on the likelihood of receiving long-term NH care, but of patients receiving long-term NH care, those in the MTI group had significantly lower total costs, shorter length of stay and lower cost per survival day. Adjusted total costs were $50,881 per long-term NH patient in the MTI group and $60,327 in the control group, a savings of 15.7% (P=.01).

Conclusion: Active methods to prevent delirium are associated with a 15.7% decrease in long-term NH costs. Shorter length of stay of patients receiving long-term NH services was the primary source of these savings.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Case-Control Studies
  • Costs and Cost Analysis / statistics & numerical data*
  • Dementia / economics
  • Dementia / prevention & control*
  • Female
  • Geriatrics / economics*
  • Hospitalization
  • Humans
  • Long-Term Care / economics*
  • Longitudinal Studies
  • Male
  • Nursing Homes / economics*
  • Randomized Controlled Trials as Topic
  • Regression Analysis