Road to the nursing home: costs and disease progression among medicare beneficiaries with ADRD

TitleRoad to the nursing home: costs and disease progression among medicare beneficiaries with ADRD
Publication TypeJournal Article
Year of Publication2012
AuthorsBentkover J., Cai S., Makineni R., Mucha L., Treglia M., Mor V.
JournalAm J Alzheimers Dis Other Demen
Volume27
Issue2
Pagination90-9
Date PublishedMar
ISBN Number1533-3175
Accession Number22495336
KeywordsAged, Aged, 80 and over, Alzheimer Disease/diagnosis/*economics, Disease Progression, Female, Health Expenditures, Humans, Long-Term Care/economics, Male, Medicare/*economics, Nursing Homes/*economics, Retrospective Studies, United States
Abstract

OBJECTIVES: To estimate long-term care costs and disease progression among Medicare beneficiaries aged 65+ with ADRD. METHODS: Retrospective analysis of Medicare Part A claims and nursing home (NH) Minimum Data Set (MDS) records among beneficiaries 1999-2007. Expenditures were grouped into 3 periods; PRE, events occurring between date of ADRD diagnosis, before first NH admission; PERI, from first NH admission to at least 100 days; and, PERM, after 120 days. Utilization and reimbursements were computed for each period. RESULTS: Demographics of the3,681,702 ADRD beneficiaries showed average age of 83 (+/-7), female (67.7%) and white (87.4%). Medicare reimbursements per person increased by 58% from the PRE ($47,912) to PERM period ($75,654). Age, ethnicity, gender (male), and comorbidities were significantly related to total reimbursements in each phase. CONCLUSIONS: Applying a taxonomy of NH phases, Medicare expenditures per person year are higher among patients in their terminal phase and higher still with comorbidities.

DOI10.1177/1533317512440494
Short TitleAmerican journal of Alzheimer's disease and other dementiasAmerican journal of Alzheimer's disease and other dementias
Alternate JournalAmerican journal of Alzheimer's disease and other dementias