Health Care Costs of Alzheimer’s and Related Dementias Within a Medicare Managed Care Provider

Bibliographic Data

ID9101353
AuthorsPaul Fishman (0000-0003-3419-4539, University of Washington, corresponding author), Paul A Fishman (Department of Health Services, University of Washington), Lindsay White (0000-0002-5298-3059, Department of Health Services, University of Washington, corresponding author), Bailey Ingraham (0009-0000-8143-7623, Department of Health Services, University of Washington, corresponding author), Sungchul Park (0000-0002-7546-9685, Drexel University), Eric B Larson (0000-0003-4782-5360, Kaiser Permanente Washington Health Research Institute, Seattle, WA), Paul Crane (Department of Health Services, University of Washington), Paul K Crane (0000-0003-4278-7465, University of Washington, corresponding author), Norma B Coe (0000-0003-1228-0938, University of Pennsylvania)
Year2020
Volume58
Issue9
Pages833-841
Publication date2020-09-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001380
PMID32826748
OpenAlexW3045847816
LanguageEN
References cited27

BACKGROUND: Although one third of Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans, there is limited information about the cost of treating Alzheimer disease and related dementias (ADRD) in these settings. OBJECTIVE: The objective of this study was to estimate direct health care costs attributable to ADRD among older adults within a large MA plan. RESEARCH DESIGN: A retrospective cohort design was used to estimate direct total, outpatient, inpatient, ambulatory pharmacy, and nursing home costs for 3 years before and after an incident ADRD diagnosis for 927 individuals diagnosed with ADRD relative to a sex-matched and birth year-matched set of 2945 controls. SUBJECT: Adults 65 years of age and older enrolled in the Kaiser Permanente Washington MA plan and the Adult Changes in Thought (ACT) Study, a prospective longitudinal cohort study of ADRD and brain aging. MEASURES: Data on monthly health service use obtained from health system electronic medical records for the period 1992-2012. RESULTS: Total monthly health care costs for individuals with ADRD are statistically greater (P<0.05) than controls beginning in the third month before diagnosis and remain significantly greater through the eighth month following diagnosis. Greater total health costs are driven by significantly (P<0.05) greater nursing home costs among individuals diagnosed with ADRD beginning in the third month prediagnosis. Although total costs were no longer significantly greater at 8 months following diagnosis, nursing home costs remained higher for the people with dementia through the 3 years postdiagnosis we analyzed. CONCLUSION: Greater total health care costs among individuals with ADRD are primarily driven by nursing home costs

Ambulatory · Ambulatory care · Cohort · Cohort study · Dementia · Disease · Family medicine · Health care · Indirect costs · MEDLINE · Minimum Data Set · Nursing homes · Retrospective cohort study · Dementia and Cognitive Impairment Research · Emergency Medicine · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Pharmacy · Surgery · Gerontology