Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer's disease and related dementias

Park, Sungchul; Chen, Jie

doi:10.21203/rs.3.rs-20317/v2

Cited by 2 publications

(2 citation statements)

References 34 publications

(38 reference statements)

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“…White beneficiaries had the highest hospice payments, however, of all racial and ethnic groups. A study of racial and ethnic differences in health care spending using the Medical Expenditure Panel Survey found similar patterns in unadjusted total spending 717 . However, after adjusting for socioeconomic characteristics and functional status, total health care spending did not significantly differ among groups.…”

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

confidence: 94%

2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,432

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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 family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes -costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI 700

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

confidence: 94%

2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,432

664

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“…There is a paucity of studies that examine heterogeneity of costs by demographic characteristics of PLWD such as race, ethnicity, and living arrangement 48 . Studies find both higher and lower medical expenditures among non‐whites compared with whites and variation across types of medical care expenditures likely reflecting differential access to care and preference for types of care 49 . Typically, PLWD have multiple comorbid conditions that contribute to healthcare use and costs 50 .…”

Section: Resultsmentioning

confidence: 99%

Impact of dementia: Health disparities, population trends, care interventions, and economic costs

Aranda

Kremer²,

Hinton

et al. 2021

J American Geriatrics Society

165

104

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Introduction The dementia experience is not a monolithic phenomenon—and while core elements of dementia are considered universal—people living with dementia experience the disorder differently. Understanding the patterning of Alzheimer's disease and related dementias (ADRD) in the population with regards to incidence, risk factors, impacts on dementia care, and economic costs associated with ADRD can provide clues to target risk and protective factors for all populations as well as addressing health disparities. Methods We discuss information presented at the 2020 National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers, Theme 1: Impact of Dementia. In this article, we describe select population trends, care interventions, and economic impacts, health disparities and implications for future research from the perspective of our diverse panel comprised of academic stakeholders, and persons living with dementia, and care partners. Results Dementia incidence is decreasing yet the advances in population health are uneven. Studies examining the educational, geographic and race/ethnic distribution of ADRD have identified clear disparities. Disparities in health and healthcare may be amplified by significant gaps in the evidence base for pharmacological and non‐pharmacological interventions. The economic costs for persons living with dementia and the value of family care partners' time are high, and may persist into future generations. Conclusions Significant research gaps remain. Ensuring that ADRD healthcare services and long‐term care services and supports are accessible, affordable, and effective for all segments of our population is essential for health equity. Policy‐level interventions are in short supply to redress broad unmet needs and systemic sources of disparities. Whole of society challenges demand research producing whole of society solutions. The urgency, complexity, and scale merit a “whole of government” approach involving collaboration across numerous federal agencies.

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Racial and ethnic patterns and differences in health care expenditures among Medicare beneficiaries with and without cognitive deficits or Alzheimer's disease and related dementias

Cited by 2 publications

References 34 publications

2022 Alzheimer's disease facts and figures

2022 Alzheimer's disease facts and figures

Impact of dementia: Health disparities, population trends, care interventions, and economic costs

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