Open AccessTrends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries
Author(s) -
Desai Urvi,
Kirson Noam Y.,
Ye Wenyu,
Mehta Nori R.,
Wen Jody,
Andrews J. Scott
Publication year - 2019
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1016/j.dadm.2018.12.005
Subject(s) - medicine , emergency department , retrospective cohort study , disease , propensity score matching , cohort , emergency medicine , cohort study , pediatrics , psychiatry
This study evaluates rates of all‐cause emergency department visits, all‐cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis. Methods Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged ≥ 65 years and have continuous Medicare enrollment for ≥4 years before the index date (AD cohort: first AD diagnosis in 2012–2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score‐matched cohorts. Results Each year, before index, patients with AD were more likely to have all‐cause emergency department visits, all‐cause hospitalizations, potentially avoidable hospitalizations, and falls ( P < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes. Discussion The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.