Medical and nursing home costs: From cognitively unimpaired through dementia.
cognitive status
cost
dementia
economics
mild cognitive impairment
nursing home
Journal
Alzheimer's & dementia : the journal of the Alzheimer's Association
ISSN: 1552-5279
Titre abrégé: Alzheimers Dement
Pays: United States
ID NLM: 101231978
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
02
05
2021
received:
20
08
2020
accepted:
17
05
2021
pubmed:
6
9
2021
medline:
21
4
2022
entrez:
5
9
2021
Statut:
ppublish
Résumé
Efforts to model the cost-effectiveness of managing/modifying cognitive impairment lack reliable, objective, baseline medical, and nursing-home (NH) costs. A stratified-random sample of Olmsted County, MN, residents ages 70-89 years (N = 3545), well-characterized as cognitively unimpaired, mild cognitive impairment (MCI), or dementia, were followed forward ≤1 year in provider-linked billing data and the Centers for Medicare & Medicaid Services NH assessments. Direct medical/nursing home/medical + NH costs were estimated. Costs were stratified by vital status and NH-use intensity (NH days/follow-up days [0%, 1% to 24%, 25% to 99%, and 100%]). Between-category mean-annual cost differences were adjusted for patient characteristics and follow-up days. Costs/follow-up day distributions differed significantly across cognitive categories. Mean costs/follow-up days were 2.5 to 18 times higher for decedents versus survivors. Among all persons with MCI, <9% with any NH use accounted for 18% of all total annual medical + NH costs. Adjusted-between-category comparisons revealed significantly higher medical and medical + NH costs for MCI versus cognitively unimpaired. Cost-effectiveness for managing/modifying both MCI and dementia should consider end-of-life costs and NH-use intensity. Results can help inform cost-effectiveness models, predict future-care needs, and aid decision-making by individuals/providers/payers/policymakers.
Identifiants
pubmed: 34482623
doi: 10.1002/alz.12400
pmc: PMC8897513
mid: NIHMS1709873
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
393-407Subventions
Organisme : NIA NIH HHS
ID : R01 AG034676
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG058738
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG006786
Pays : United States
Informations de copyright
© 2021 the Alzheimer's Association.
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