Economic burden of dehydration among hospitalized elderly patients

Purpose: The cost of unnecessary hospitalizations associated with dehydration in elderly patients was studied. Methods: The study involved a retrospective examination of 1999 data on hospital discharges from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. The procedure code for volume depletion was used to extract hospitalization episodes for patients greater than or equal to65 years of age who had a principal diagnosis of dehydration and were discharged alive. Hospitalizations with procedure codes unrelated to dehydration were omitted. Results: The descriptive findings indicated that hospitalized older patients with a principal diagnosis of dehydration averaged 80.4 years of age, were primarily white (82.5%), and were more likely to live in the community than in a nursing home. Hospitalizations for dehydration were more common in the South and less common in the West. The average length of stay (LOS) was 4.6 days. The average total hospital charge was $7,442, and the average per them charge was $1,628. Regression analysis explained nearly half of the variation in charges for dehydration (R-2 = 0.457). Average LOS and number of diagnoses were directly related to hospital charges, and age was inversely related. Higher charges were associated with being nonwhite, entering the hospital via the emergency room, having private insurance, having no insurance, having comorbidities, and being hospitalized in the West or in teaching or urban hospitals. In 1999, the potential national saving from avoidable hospitalizations in these patients could have been as much as $1.14 billion. Conclusion: The economic burden associated with avoidable hospitalizations due to dehydration in elderly patients was substantial.