Health Affairs Publishes Two Age-Friendly Health Papers in September Issue
Two Age-Friendly Health series papers have been published in the September 2023 issue of Health Affairs.
The Age-Friendly Health series aims to inform health policies and covers new issues related to building more equitable, high-quality health systems for older adults.
Health Care Costs Associated With Hospice Use For People With Dementia In The US by Melissa D. Aldridge, Lauren J. Hunt, Krista L. Harrison, Karen McKendrick, Lihua Li and R. Sean Morrison
Hospice enrollees with dementia are the fastest-growing group of hospice users in the US and policy makers have growing concerns that the Medicare hospice benefit among people with dementia is driving up costs. The authors' objective was to understand the overall economic impact of hospice use for people with dementia by estimating the association between hospice use by people with dementia and Medicare healthcare costs.
The authors found that among community-dwelling people with dementia, Medicare costs were lower for those who used hospice than for those who did not, where cost savings were primarily attributed to lower inpatient care costs in the last days of life. The authors noted similar findings in nursing homes, where total and Medicare costs were lower for hospice users with dementia who enrolled within a month of death than for those who did not use hospice. The authors write, "Medicare policies that reduce hospice access and incentivize hospice disenrollment may actually increase Medicare costs, given that hospice cost savings generally derive from a person's last days or weeks of life."
The Effect Of Labor Unions On Nursing Home Compliance With OSHA's Workplace Injury And Illness Reporting Requirement by Adam Dean, Jamie McCallum, Atheendar S. Venkataramani and David Michaels
Nursing home workers experience one of the highest occupational injury and illness rates in the US. Although all US nursing homes are required to report injury and illness data to the Occupational Safety and Health Administration (OSHA), the authors found that the compliance rate during the period 2016-21 was only 40 percent. Using a difference-in-differences study design and data from the Service Employees International Union, the authors found that two years after unionization, nursing homes were 31.1 percentage points more likely to report workplace injury and illness data to OSHA than those in a nonunion nursing home. This study suggests that labor unions may be a crucial partner in improving workplace safety in nursing homes.
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