Medicare Expenditures and Health Care Utilization in a Multiethnic Community-based Population With Dementia From Incidence to Death. (October 2018)

• Record Type: Journal Article
• Authors: Ornstein, Katherine A.; Zhu, Carolyn W.; Bollens-Lund, Evan; Aldridge, Melissa D.; Andrews, Howard; Schupf, Nicole; Stern, Yaakov
• Is Part Of: Alzheimer disease and associated disorders. Volume 32:Number 4(2018)
• Publication Date: 2018-10
• Subjects: end-of-life care -- Medicare expenditures -- Alzheimer disease costs -- Hispanics -- health disparities -- ethnicity; Alzheimer's disease -- Periodicals; Dementia -- Periodicals; 616.8305
• DOI: 10.1097/WAD.0000000000000259
• Languages: English
• ISSNs: 0893-0341

Abstract

Abstract : Introduction: While individuals live with dementia for many years, utilization and expenditures from disease onset through the end-of-life period have not been examined in ethnically diverse samples. Methods: We used a multiethnic, population-based, prospective study of cognitive aging (Washington Heights-Inwood Columbia Aging Project) linked to Medicare claims to examine total Medicare expenditures and health care utilization among individuals with clinically diagnosed incident dementia from disease onset to death. Results: High-intensity treatment (hospitalizations, life-sustaining procedures) was common and mean Medicare expenditures per year after diagnosis was $69, 000. Non-Hispanic blacks exhibited higher spending relative to Hispanics and non-Hispanic whites 1 year after diagnosis. Non-Hispanic blacks had higher total (mean=$205, 000) Medicare expenditures from diagnosis to death compared with non-Hispanic whites (mean=$118, 000). Hispanics' total expenditures and utilization after diagnosis was similar to non-Hispanic whites despite living longer with dementia. Discussion: Health care spending for patients with dementia after diagnosis through the end-of-life is high and varies by ethnicity. Abstract : Supplemental Digital Content is available in the text.