Exploring cost trajectories of patients admitted to geriatric rehabilitation in the Netherlands

OBJECTIVE: Geriatric rehabilitation (GR) is an essential component of transitional care. However, insight into longitudinal care use and related costs is limited. This study mapped GR trajectories over a six-month period, identified latent groups with similar cost patterns and examined patient-level cost drivers.

METHOD: We analysed administrative claims data from Statistics Netherlands, focusing on total trajectory costs for GR patients admitted between 1 February and 31 July 2022. Costs included hospital care (inpatient and outpatient), district nursing, long-term care (at home and in nursing homes) and short-term residential care. We used descriptive statistics, group-based trajectory modelling and logistic regression to examine differences between the identified cost groups.

RESULTS: Over six months, 27 462 patients received GR, with a mean total cost of €40 469 (SD = €23 033). Sixty-eight percent of patients returned home, of whom 17% received home-based GR. Two latent groups were identified: a lower-cost group (88%) with mean costs of €35 024 (SD = 16 408), and a higher-cost group (12%) with mean costs of €82 012 (SD = 23 928). Patient characteristics only partially explained group membership. The higher-cost group accounted for 23% of total costs, mainly due to hospital (re)admissions, nursing home admissions and longer GR stays.

CONCLUSION: GR costs were unevenly distributed: 12% of patients incurred 23% of total costs. Key factors associated with high costs were hospital care, nursing home admissions and prolonged GR stays. Early identification and better care coordination, including shifting care closer to home, may improve continuity, reduce costs and support more efficient geriatric rehabilitation delivery.