Title | Medicare expenditures attributable to dementia. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Waite, LL, Fishman, P, Basu, A, Crane, PK, Larson, EB, Coe, NB |
Journal | Health Services Research |
ISSN Number | 1475-6773 |
Keywords | Cognition & Reasoning, Dementia, Medicare linkage, Medicare/Medicaid/Health Insurance |
Abstract | OBJECTIVE: To estimate dementia's incremental cost to the traditional Medicare program. DATA SOURCES: Health and Retirement Study (HRS) survey-linked Medicare part A and B claims from 1991 to 2012. STUDY DESIGN: We compared Medicare expenditures for 60 months following a claims-based dementia diagnosis to those for a randomly selected, matched comparison group. DATA COLLECTION/EXTRACTION METHODS: We used a cost estimator that accounts for differential survival between individuals with and without dementia and decomposes incremental costs into survival and cost intensity components. PRINCIPAL FINDINGS: Dementia's five-year incremental cost to the traditional Medicare program is approximately $15 700 per patient, nearly half of which is incurred in the first year after diagnosis. Shorter survival with dementia mitigates the incremental cost by about $2650. Increased costs for individuals with dementia were driven by more intensive use of Medicare part A covered services. The incremental cost of dementia was about $7850 higher for females than for males because of sex-specific differential mortality associated with dementia. CONCLUSIONS: Dementia's cost to the traditional Medicare program is significant. Interventions that target early identification of dementia and preventable inpatient and post-acute care services could produce substantial savings. |
DOI | 10.1111/1475-6773.13134 |
User Guide Notes | |
Alternate Journal | Health Serv Res |
Citation Key | 10063 |
PubMed ID | 30868557 |
PubMed Central ID | PMC6606539 |
Grant List | R01-AG049815 / AG / NIA NIH HHS / United States SIP-14-005 / CC / CDC HHS / United States |