The relationship between a dementia diagnosis, chronic illness, medicare expenditures, and hospital use

J. P.W. Bynum, P. V. Rabins, W. Weller, M. Niefeld, G. F. Anderson, A. W. Wu

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To determine whether dementia independent of age and comorbidity increases health care utilization in the United States. DESIGN: Cross-sectional analysis of claims using a 5% random sample of fee-for-service Medicare beneficiaries in 1999 (N = 1,238,895). RESULTS: Prevalence of dementia was 8.3%. In an adjusted model, dementia was associated with an incremental cost of $6,927, or 3.3 times greater total expenditures than in nondementia patients (P < .001). Hospitalization accounted for 54% of adjusted costs. The adjusted odds of hospitalization associated with dementia were 3.68 (95% confidence interval (CI) = 3.62-3.73) and adjusted odds of potentially preventable hospitalization were 2.40 (95% CI = 2.35-2.46). These findings were consistent across all burdens of comorbid chronic conditions. CONCLUSION: A diagnosis of dementia is independently associated with increased acute care utilization. Further study is needed into the factors associated with high rates of hospitalization in dementia patients including aspects of ambulatory management that may be improved.

Original languageEnglish (US)
Pages (from-to)160-164
Number of pages5
JournalResearch and Practice in Alzheimer's Disease
Volume10
StatePublished - Dec 1 2005

Keywords

  • Comorbid illness
  • Dementia
  • Hospitalization
  • Utilization

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Aging
  • Geriatrics and Gerontology
  • Biological Psychiatry

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