The purpose of this study was to identify the characteristics of older-adult inpatients in tertiary hospitals and to analyze their medical expenses based on their characteristics. This investigation was a retrospective descriptive study. A total of 7,790 adults aged 65 years and older, who were hospitalized from January 1–December 31, 2015, were included in the study. Data were analyzed using the t-test, ANOVA, and Scheffé post-hoc test. There were statistically significant differences by arrival method, ambulation, and discharge status between medical expenses per hospitalization and medical expenses per day of hospitalization among the hospitalized older adults. As for total medical expenses, “neoplasms,” “diseases of the circulatory system,” and “injuries, poisoning, and certain other consequences of external causes,” incurred the highest expenses. The target population of tertiary hospitals’ services should include not only acute patients but also older adults with severe chronic diseases. Cost-cutting efforts made for older patients should be consistent with their healthcare needs.

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