The rise in the incidence of hospitalizations for the aged, 1967 to 1979.

Since the beginning of the Medicare program in July 1966, the rate of hospitalization for persons age 65 and over has risen steadily. The rate grew more for the aged than for younger age groups. Because of concern about the appropriateness and cost of hospital care, this article examines the increase in hospitalizations for the aged and attempts to identify factors that may explain why the discharge rate rose more for the aged than for younger persons. The article shows that most of the increase in the discharge rate among the aged was associated with an increase in the percentage of persons using the hospital rather than with an increase in rate of multiple hospitalizations. There was also a large increase in the rate of hospital stays of short duration. Examination of changes in diagnostic and surgical case-mix showed that there was a large increase in vascular and cardiac surgeries. Changes in demographic composition and insurance coverage did not help explain the difference in the rate of growth of hospitalizations by age group. The increase in the rate of the aged being cared for in the hospital raises the question of the necessity and quality of the care they receive. Additional studies should focus on the nature and appropriateness of the hospital services rendered to the elderly.