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Impact of Dementia on Payments for Long-term and Acute Care in an Elderly Cohort

Datos Bibliográficos

ID9104280
AutoresGreg Arling (0000-0001-8563-9433, Indiana University School of Medicine, autor de correspondencia), Wanzhu Tu (0000-0002-4236-9135, Regenstrief Institute, autor de correspondencia), Timothy E Stump (0000-0001-9593-3011, Cancer Research And Biostatistics), Marc B Rosenman (Indiana University School of Medicine), Steven R Counsell (Indiana University School of Medicine, autor de correspondencia), Christopher M Callahan (0000-0002-4617-6672, Indiana University School of Medicine, autor de correspondencia)
Año2013
Volumen51
Número7
Páginas575-581
Fecha de publicación2013-07-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31828d4d4a
PMID23756644
PMCIDPMC3680786
OpenAlexW1985476977
IdiomaEN
Citas recibidas3
Referencias citadas17

BACKGROUND: Older people with dementia have increased risk of nursing home (NH) use and higher Medicaid payments. Dementia's impact on acute care use and Medicare payments is less well understood. OBJECTIVES: Identify trajectories of incident dementia and NH use, and compare Medicare and Medicaid payments for persons having different trajectories. RESEARCH DESIGN: Retrospective cohort of older patients who were screened for dementia in 2000-2004 and were tracked for 5 years. Trajectories were identified with latent class growth analysis. SUBJECTS: A total of 3673 low-income persons aged 65 or older without dementia at baseline. MEASURES: Incident dementia diagnosis, comorbid conditions, dual eligibility, acute and long-term care use and payments based on Medicare and Medicaid claims, medical record systems, and administrative data. RESULTS: Three trajectories were identified based on dementia incidence and short-term and long-term NH use: (1) high incidence of dementia with heavy NH use (5% of the cohort) averaging $56,111/year ($36,361 Medicare, $19,749 Medicaid); (2) high incidence of dementia with little or no NH use (16% of the cohort) averaging $16,206/year ($14,644 Medicare, $1562 Medicaid); and (3) low incidence of dementia and little or no NH use (79% of the cohort) averaging $8475/year ($7558 Medicare, $917 Medicaid). CONCLUSIONS: Dementia and its interaction with NH utilization are major drivers of publicly financed acute and long-term care payments. Medical providers in Accountable Care Organizations and other health care reform efforts must effectively manage dementia care across the care continuum if they are to be financially viable

Cohort · Cohort study · Dementia · Disease · Health care · Incidence (geometry) · Long-term care · Medicaid · Psychiatry · Retrospective cohort study · Dementia and Cognitive Impairment Research · Emergency Medicine · Geriatric Care and Nursing Homes · Internal Medicine · Medicine · Palliative Care and End-of-Life Issues · Gerontology

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Obras citantes distintas3
Citas por año0,3
Intervalo de citas2016 - 2021 (6)
Velocidad de citaciónhistorical
Altamente citadoNo
Tipos de citaNeutras: 3
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