Survival of adult high-cost patients. Report of a follow-up study from nine acute-care hospitals

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Abstract
To assess the degree to which high-cost illness is terminal illness, survival data were obtained on a random sample of 776 adult high-cost patients from 9 acute-care hospitals in the San Francisco Bay [USA] area. At 2 yr after discharge, at least 34% of high-cost patients had died. These patients accounted for 39% of the hospital charges incurred by the total group of patients studied. Among the factors significantly associated with death were a diagnosis of cancer (62% death), age older than 64 yr (44% death), discharge from a medical (as opposed to surgical) service (42% death) and hospital bill of .apprx. 10,000 and more (48% death). In-hospital and posthospital death rates varied greatly among the 9 hospitals. Apparently large amounts of medical care are consumed by patients with unfavorable prognoses.

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