Factors Related to the Increase in Hospital Costs of the Elderly With Circulatory Disease in Ahvaz City in 2015-2016 With the Approach of the Generalized Gamma Marginalized Two-Part Model

Objectives: One of the challenges facing today's societies is the increasing health care costs of the elderly. Therefore, identifying the factors associated with increasing health costs for the elderly can help health policymakers control the costs imposed on families and society. The purpose of this study was to identify the factors related to the increase in hospital costs of the elderly with circulatory disease in Ahvaz city in 2015-2014 with the approach of a generalized gamma marginalized two-part model. Methods and Materials: In this retrospective cohort study, after obtaining the code of ethics, 335 samples were selected by simple random sampling from patients of Imam Khomeini and Golestan hospitals in Ahvaz. Subjects with characteristics of circulatory diseases and age equal to or over 60 years were included in the study. The relationship between age, sex, admission status in critical care unit, marital status, hospital admission season and number of hospitalization days with increasing treatment costs of the elderly was investigated using the generalized gamma marginalized two-part model and SAS9.4 software. In this study, the response variable was patients' treatment costs. Significance level was considered 0.05. Results: The mean age of the elderly in this study was 70.71 8.27. Female elderly accounted for 54% and male elderly for 46% of patients. The average cost of medical services for patients admitted to the CCU was 3.70 times that of patients who were not admitted to this ward. Also, for each day more hospital stay, the average medical expenses of the patient increase 1.11 times. The odds ratio for the sex variable showed that hospital costs for men were 1.67 times higher than for women. This amount was 2 times higher for single elderly than for married. In addition, with each passing year of age 60, the average cost of health care increased 0.96 times. Using the generalized gamma marginalized two-part model, it was found that the variables of age, number of hospitalization days, marital status, sex, and admission status in critical care unit at the level of 0.05 had a significant effect on increasing the average treatment costs of the elderly. Conclusion: The results showed that the burden of treatment costs on individuals and society is higher in younger elderly. Older men than women as well as single elderly compared to married face heavier hospital costs. The increase in the number of hospitalization days is another factor in the considerable increase in hospital costs; Especially when the elderly need critical care. Therefore, these factors will be effective in increasing the costs imposed on the elderly and the society which forward to aging population.