@article {9013, title = {Medicare Expenditures Associated With Hospital and Emergency Department Use Among Beneficiaries With Dementia.}, journal = {Inquiry}, volume = {54}, year = {2017}, month = {2017 Jan}, pages = {46958017696757}, abstract = {Understanding expenditure patterns for hospital and emergency department (ED) use among individuals with dementia is crucial to controlling Medicare spending. We analyzed Health and Retirement Study data and Medicare claims, stratified by beneficiaries{\textquoteright} residence and proximity to death, to estimate Medicare expenditures for all-cause and potentially avoidable hospitalizations and ED visits. Analysis was limited to the Medicare fee-for-service population age 65 and older. Compared with people without dementia, community residents with dementia had higher average expenditures for hospital and ED services; nursing home residents with dementia had lower average expenditures for all-cause hospitalizations. Decedents with dementia had lower expenditures than those without dementia in the last year of life. Medicare expenditures for individuals with and without dementia vary by residential setting and proximity to death. Results highlight the importance of addressing the needs specific to the population with dementia. There are many initiatives to reduce hospital admissions, but few focus on people with dementia.}, keywords = {Dementia, Emergency services, Medicare linkage, Older Adults}, issn = {1945-7243}, doi = {10.1177/0046958017696757}, author = {Daras, Laura Coots and Feng, Zhanlian and Joshua M Wiener and Kaganova, Yevgeniya} } @article {8078, title = {Hospital And ED Use Among Medicare Beneficiaries With Dementia Varies By Setting And Proximity To Death}, journal = {Health Affairs}, volume = {33}, year = {2014}, pages = {683-690}, publisher = {33}, abstract = {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.}, keywords = {Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance}, doi = {10.1377/hlthaff.2013.1179}, url = {http://content.healthaffairs.org/content/33/4/683.abstract}, author = {Feng, Zhanlian and Coots, Laura A. and Kaganova, Yevgeniya and Joshua M Wiener} }