Health Disparities in Cost of Care in Patients With Alzheimer’s Disease

Gilligan, Adrienne M.; Malone, Daniel C.; Warholak, Terri; Armstrong, Edward P.

doi:10.1177/1533317512467679

Cited by 47 publications

(49 citation statements)

References 35 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, Gilligan and colleagues (2013) found significant differences between minorities and whites and among minority groups in Medicaid payments for health costs among patient admissions with AD. [47] Moreover, our findings support potential racial disparities in hospitalization characteristics among AD patient admissions, which may explain the racial disparities observed in care costs. However, future research is needed to further investigate other socio-demographic factors that may explain why these differences are occurring.…”

Section: Discussionsupporting

confidence: 71%

Nationwide Inpatient Prevalence, Predictors, and Outcomes of Alzheimer’s Disease among Older Adults in the United States, 2002–2012

Beydoun

Gamaldo

et al. 2015

JAD

View full text Add to dashboard Cite

In the inpatient setting, prevalence, predictors and outcomes (mortality risk (MR), length of stay (LOS) and total charges (TC)) of Alzheimer’s Disease (AD) are largely unknown. We used data on older adults (60y+) from the Nationwide Inpatient Sample (NIS) 2002–2012. AD prevalence was ~3.12% in 2012 (total weighted discharges with AD±standard error: 474,410±6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR=1.67, 95%CI:1.63–1.71, p<0.001), fluid/electrolyte disorders (OR=1.25, 95%CI:1.22–1.27, p<0.001), weight loss (OR=1.26, 95%CI:1.22–1.30, p<0.001) and psychosis (OR=2.59, 95%CI:2.47–2.71, p<0.001), with mean total co-morbidities increasing over-time. AD was linked to higher MR, longer LOS but lower TC. TC rose in AD, while MR and LOS dropped markedly over-time. In AD, co-morbidities predicting simultaneously higher MR, TC and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders and weight loss. In sum, co-morbidities and TC increased over-time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.

show abstract

Section: Discussionsupporting

confidence: 71%

Nationwide Inpatient Prevalence, Predictors, and Outcomes of Alzheimer’s Disease among Older Adults in the United States, 2002–2012

Beydoun

Gamaldo

et al. 2015

JAD

View full text Add to dashboard Cite

show abstract

“…Gilligan et al analyzed cost of care in Medicaid patient populations and found that among individuals who received 1 unique AD medication, total health care expenditures decreased significantly compared to those receiving no pharmacotherapy (p < 0.001); however, when level of exposure increased to 2 or more drugs, there was no difference in cost between individuals who received medication therapy as compared to those who received none [28]. A systematic review conducted by Cappell et al examining pharmacoeconomic studies of these medications also suggests that cost of care is lower when AD patients receive pharmacotherapy [27].…”

Section: Discussionmentioning

confidence: 99%

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

Adrienne¹,

Daniel²,

Terri³

et al. 2013

AAD

View full text Add to dashboard Cite

show abstract

“…In a study of Medicaid beneficiaries with a diagnosis of Alzheimer's dementia that included both Medicaid and Medicare claims data, researchers found significant differences in the costs of care by race/ethnicity 576 . These results demonstrated that black/African Americans had significantly higher costs of care than whites or Hispanics/Latinos, primarily due to more inpatient care and more comorbidities.…”

Section: Use and Costs Of Health Care Long‐term Care And Hospicementioning

confidence: 99%

2020 Alzheimer's disease facts and figures

2020

Alzheimer's & Dementia

1,880

653

View full text Add to dashboard Cite

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid‐century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers’ increased risk for emotional distress and negative mental and physical health outcomes. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.

show abstract

Health Disparities in Cost of Care in Patients With Alzheimer’s Disease

Abstract: Disparities in cost among minority-to-minority populations were just as prevalent, if not higher, than minority-white disparities.

Cited by 47 publications

References 35 publications

Nationwide Inpatient Prevalence, Predictors, and Outcomes of Alzheimer’s Disease among Older Adults in the United States, 2002–2012

Nationwide Inpatient Prevalence, Predictors, and Outcomes of Alzheimer’s Disease among Older Adults in the United States, 2002–2012

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

2020 Alzheimer's disease facts and figures

Contact Info

Product

Resources

About