Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries

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Abstract

Introduction: 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.

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Desai, U., Kirson, N. Y., Ye, W., Mehta, N. R., Wen, J., & Andrews, J. S. (2019). Trends in health service use and potentially avoidable hospitalizations before Alzheimer’s disease diagnosis: A matched, retrospective study of US Medicare beneficiaries. Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring, 11, 125–135. https://doi.org/10.1016/j.dadm.2018.12.005

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