Medicare expenditures and health care utilization in a multiethnic community-based population with dementia from incidence to death

Katherine A. Ornstein, Carolyn W. Zhu, Evan Bollens-Lund, Melissa D. Aldridge, Howard Andrews, Nicole Schupf, Yaakov Stern

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)320-325
Number of pages6
JournalAlzheimer Disease and Associated Disorders
Volume32
Issue number4
DOIs
StatePublished - 2018

Keywords

  • Alzheimer disease costs
  • Hispanics
  • Medicare expenditures
  • end-of-life care
  • ethnicity
  • health disparities

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