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P2‐371: Ethnic/Cultural differences in the incremental cost of health care services associated with Alzheimer's disease
Author(s) -
McCombs Jeffrey,
Chu Karen,
Mucha Lisa
Publication year - 2011
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2011.05.1246
Subject(s) - medicaid , ethnic group , medicine , demography , gerontology , disease , health care , sociology , anthropology , economics , economic growth
Background: Higher cost for nursing home care [LTC] is the primary factor behind the incremental cost of Alzheimer’s Disease [AD]. The use of LTC services to treat patients with AD may be sensitive to culture and ethnic mores related to the care of elder family members. This study investigates if ethnic/ cultural differences exist in the incremental costs associatedwithAD.Methods: Patients age 50+ were identified from de-identified Medicaid paid claims from California [MediCal]. All patients were MediCal eligible for the period 20042006 [survivors]. AD patients had at least one AD diagnosis. A 20% random sample of non-AD patients was selected and amatched control group was identified using propensity score methods. Health care costs were summed over all three years broken down by type of service. Multivariate statistical models were estimated to document the incremental impact of AD on costs controlling for baseline characteristics, including race. Interaction terms between race and the AD indicator variable were used to measure racial difference in the impact of AD on cost by type of service relative to whites. Results: The incremental cost of AD in white patients was $52,827 over 3 years, primarily due to higher costs of $37,258 for LTC, $5,147 for acute hospital serviceswith non-significant increases in home health costs [$2,268] and medical costs [$7,782]. Black patients withAD consumed an additional $7,886 in LTC and $10,620 in total costs relative towhite patientswithAD.HispanicADpatients accrued $25,666 less in total cost than white AD patients, primarily due to lower LTC costs of $21,531. Asian AD patients accrued $34,780 less in total costs and $20,962 less in LTC costs than white AD patients. Over half of patients did not have data on race in the Medi-Cal records. While AD patients with no race data also accrued lower LTC costs thanwhite AD patients [-$33,859], they consumed significantlymore home health care [+$22,972] and medical care [+$24,962] than white AD patients. Conclusions: Ethnicity has very significant impact on the total cost of care provided to AD patients with Asian and Hispanic patients consuming less LTC services.