Exploration of health care utilization, social care utilization and costs for individuals discharged from inpatient geriatric care in Sweden - a registry data study

Background Individuals receiving geriatric care are often frail and afflicted with multiple chronic conditions demanding care from several medical disciplines, and from several different care providing units across the health systems. Objective To explore the six-month service utilization and direct costs attributed to individuals receiving geriatric inpatient care. Methods Health care utilization– in terms of inpatient care, outpatient visits with different health care professions– and social care utilization– in terms of social services, and stay at residential care facility (RCF)– were quantified based on registry data, for a cohort admitted to geriatric inpatient care in Stockholm, Sweden during 2016. Results On average, individuals admitted to geriatric inpatient care in Stockholm had 12.8 inpatient care days, 32.1 visits in outpatient care, 432 h of home care and 28.8 days of staying at RCF, during the first six months after discharge. This amounted to an average cost of 722 thousand Swedish kronor (SEK), € 64 900, in 2023 monetary value. Costs were on average 37% attributable to inpatient care including the initial inpatient stay, 12% to outpatient visits, 38% to social services at home, and 13% to stay at residential care facility (whereof 11% short-term, 89% long-term). Total costs differed significantly between groups based on function, age and main diagnosis. Conclusion Costs of care for individuals treated at geriatric department are substantial. The variation of cost is also significant; higher age and lower function were associated with higher health care and social care costs. Major cost buckets were inpatient health care (region-financed) and social care at home (municipality-financed).