Loss of Mind and Money: Delirium and its Costs

MUSC study finds economic impact of delirium sizeable, rivals diabetes costs

CHARLESTON -- A Medical University of South Carolina (MUSC) study found that total health care cost estimates attributable to delirium ranged from $16,303 to $64,421 per elderly patient. These estimates represent a national burden of delirium on the health care system extending from $38 to $152 billion each year, much more than previously thought. The spotlight on health care costs frequently rests on other medical conditions, like diabetes. According to the American Diabetes Association in 2002, direct and indirect medical costs attributable to diabetes were estimated at $132 billion annually.

"This study shows that the economic burden of delirium is considerable," said lead investigator Douglas L. Leslie, Ph.D., MUSC Department of Health Administration and Policy. "Our hope is that these results will draw attention to delirium as a serious condition with significant long-term implications. Given that interventions exist that have been shown to reduce rates of delirium, at least some of these costs may be preventable."

Despite recognition of delirium as a serious and potentially preventable condition, Leslie said its long-term implications are not well understood. He and study colleagues from Harvard Medical School, the Institute for Aging Research Hebrew SeniorLife, a comprehensive senior housing and health care system, and Yale School of Medicine suggest their results highlight the need for increased efforts to mitigate this clinically significant and costly disorder. A full discussion of their work and findings can be found in the Jan.14, 2008 issue of the AMAís (American Medical Association) Archives of Internal Medicine.

In a grant supported by the National Institutes of Health's Institute on Aging, Leslie and his co-investigators used data from Medicare administrative files, hospital billing records, and the Connecticut Long-Term Care Registry to compute one-year health care costs for a cohort of 841 hospitalized older persons aged 70 years or older. One hundred and nine patients (13 percent) from this group developed delirium. Patients with delirium had significantly higher health care costs and survived fewer days than patients without delirium. Data were adjusted for patient sociodemographic and clinical characteristics. Overall, the work highlights the importance of delirium, and should bring heightened attention to this devastating medical disorder for older persons.

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.3 billion. MUSC operates a 600-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit www.musc.edu or www.muschealth.com.

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