Hospital And ED Use Among Medicare Beneficiaries With Dementia Varies By Setting And Proximity To Death

TitleHospital And ED Use Among Medicare Beneficiaries With Dementia Varies By Setting And Proximity To Death
Publication TypeJournal Article
Year of Publication2014
AuthorsFeng, Z, Coots, LA, Kaganova, Y, Wiener, JM
JournalHealth Affairs
KeywordsHealth Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance

Hospitalizations and emergency department (ED) visits for people with Alzheimer s disease and related disorders are of particular concern because many of these patients are physically and mentally frail, and the care delivered in these settings is costly. Using data from the Health and Retirement Study linked with Medicare claims from the period 2000 08, we found that among community-dwelling elderly fee-for-service Medicare beneficiaries, those who had dementia were significantly more likely than those who did not to have a hospitalization (26.7 percent versus 18.7 percent) and an ED visit (34.5 percent versus 25.4 percent) in each year. Comparing nursing home residents who had dementia with those who did not, we found only small differences in hospitalizations (45.8 percent versus 41.9 percent, respectively) and ED use (55.3 percent versus 52.7 percent). As death neared, however, utilization rose sharply across settings and by whether or not beneficiaries had dementia: Nearly 80 percent of community-dwelling decedents were hospitalized, and an equal proportion had at least one ED visit during the last year of life, regardless of dementia. Our research suggests that substantial portions of hospitalizations and ED visits both before and during the last year of life were potentially avoidable.

Endnote Keywords

Hospitalization/Emergency department/Alzheimers dementia/Long-Term Care/Medicare/Medicaid/Chronic Care

Endnote ID


Citation Key8078