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Medicare Expenditures and Healthcare Utilization in a Multi-ethnic Community-based Population with Dementia from Incidence to Death

Ornstein, Katherine A.; temp:cf7b315d8efb433c122b194f1904df21b576d6940da788d52731cbc0814c4fa6; Bollens-Lund, Evan; Aldridge, Melissa D.; Andrews, Howard F.; Schupf, Nicole; Stern, Yaakov

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.

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Title
Alzheimer Disease and Associated Disorders
DOI
https://doi.org/10.1097/WAD.0000000000000259

More About This Work

Academic Units
Neurology
Published Here
May 4, 2021