1. Purpose Results A National Estimate of the Cost of Nursing Home Care for Patients with Parkinson ’ s disease Katherine Anderson, Richard Faris, Lawrence Brown, Dick Gourley, Greta Gourley, Carol Likens, Shelley White-Means The University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN The purpose of this study was to estimate nursing home costs for patients with Parkinson’s disease in the United States. NHC-001P Person Characteristics Round one NHC-002 Person Characteristics Full Year Demographics NHC-007 Nursing Home Expenditures NHC-001F Facility Characteristics Round 1 NHC-003 Characteristics Full Year Demographics Person-Level File Merge for Nursing Home Component Facility-Level File Merge for Nursing Home Component Final Merge of Nursing Home Component 1996 Data In 1996 the Medical Expenditures Panel Survey Nursing Home Component (MEPS-NHC) was conducted by the Agency for Healthcare Research and Quality. The MEPS- NHC was a survey of nursing homes and persons residing in nursing homes during the 1996 calendar year. The MEPS- NHC found that in 1996, there were approximately 1.5 million nursing home residents in the United States. 1 Figure 1 Background Conclusions The results presented here provide a baseline for the overall cost of nursing home care for patients with Parkinson ’ s disease. Further research is needed to determine if costs for patients with Parkinson ’ s disease residing in nursing homes are similar to nursing home costs for patients without Parkinson ’ s disease. The estimate presented here looked at total overall cost for nursing home care for patients with Parkinson ’ s disease. Finally, more current nursing home data are needed to more accurately estimate present day cost of nursing home care for patients with Parkinson ’ s disease. Methods The Medical Expenditures Panel Survey Nursing Home Component (MEPS-NHC) was used to estimate the cost of nursing home care for patients with Parkinson’s disease. Access to the MEPS-NHC is through the CFACT-Data Center (Center for Financing, Access and Cost Trends Data Center) located in Rockville, MD. Demographic variables, race, age, gender and marital status were collected for patients living in nursing homes that reported having Parkinson’s disease. Costs for the patient and the nursing home facility were also collected for data analysis. In order to analyze the MEPS-NHC data it was necessary to link multiple files together to create one file for analysis. The person level files (NHC001P, NHC-002, and NHC-007) were merged using the original person identification number (ORIGPERSID) resulting in the creation of one person level file. The facility level files (NHC-001F and NHC-003) were merged using the sample facility identification number (SFID) and this resulted in one facility level file. The SFID appeared in NHC-002 of the person level files and was used as the common variable to merge the single person level file and facility level files that were created into one final merged file. Formula 1 illustrates variables used from the MEPS-NHC to determine the weighted cost of nursing home care for people with Parkinson ’ s disease. Figure 1 depicts how Nursing Home Component (NHC) files were merged together to create one file for data analysis. 1.Krauss N, Altman B. Characteristics of nursing home residents-1996. Rockville, MD, Agency for Health Care Policy and Research; 1998 MEPS Research Findings No. 5. AHCPR Pub. No. 99-0006 tirmfawt * exptotx = patient weighted cost Table 1 provides the overall mean and confidence limits for average nursing home costs in 1996. Table 1 also provides the results of the t-test between mean nursing home costs and selected demographics. The average cost of nursing home care for females was $31,506 and $33,544 for males. A significant difference in the mean nursing home costs between females and males with Parkinson ’ s disease residing in nursing homes does not exist. Using assigned patient weights, the 208 patients in the MEPS-NHC represented 99,989 Parkinson ’ s patients in nursing home facilities in the United States. The weighted total for nursing home costs for patients with Parkinson ’ s disease in 1996 was $3.2 billion. The weighted total nursing home cost for males in 1996 was $1.14 billion and $2.08 billion for females. The majority of nursing home patients with Parkinson ’ s disease were white (94.23%) and over the age of 80 (60.58%). Almost half (48%) of the patients were widowed and 28% were married. The remaining 23% of Parkinson ’ s patients were single, divorced, or separated. The weighted total for nursing home costs for patients with Parkinson ’ s disease in 1996 was $3.2 billion. The weighted total nursing home cost for males in 1996 was $1.14 billion and for females the weighted total cost was $2.08 billion. The Nursing Home Consumer Price Index (CPI) was used to calculate the 1996 estimate into 2005 dollars. The 1996 amount of $3.2 billion would be $4.7 billion in 2005 dollars. Demographic Unweighted Number Weighted Number Gender Males7434,061 Females13465,928 Age Under 808233,149 Over 8012666,570 Marital Status Single4722,166 Married60 Widowed100 Unknown1524 Education No High School8435,233 High School3112,923 College (BS, MS, PhD)3528,286 Don’t Know5823,547 Overall20899,989 Formula 1: Table 2: Demographics of Nursing Home Patient ’ s with Parkinson ’ s Disease DemographicNMeant- value Females134$31,506.4087 Males74$33,5444087 Less than age 80 82$32,350.9199 Over age 80126$32,208.9199 Less than High School 84$32,072.8856 High School or greater 66$32,108.8856 Table 1: Results of t-test between nursing home care for selected demographics