National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Caregiving (5)
- (-) Dementia (14)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (8)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Healthcare Costs (3)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
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- Long-Term Care (2)
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- Medication (3)
- Mortality (1)
- Neurological Disorders (8)
- Nursing Homes (3)
- Outcomes (1)
- Patient and Family Engagement (1)
- Prevention (2)
- Racial and Ethnic Minorities (1)
- Risk (2)
- Shared Decision Making (2)
- Social Determinants of Health (1)
- Telehealth (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedAnderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
O'Connell J, Grau L, Goins T
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
This study analyzed the costs of treatment for all-cause dementia among American Indians and Alaska native (AI/AN) adults who access services through the Indian Health Service (IHS) and Tribal health programs. The authors analyzed fiscal year 2013 IHS/Tribal treatment costs for AI/ANs aged 65 and over with dementia and a matched sample without dementia (n= 1842). Mean total treatment costs for adults with dementia were $5400 higher than for adults without dementia ($13,027 versus $7627). The difference in adjusted total treatment costs was $2943, the majority of which was due to the difference in hospital inpatient costs.
AHRQ-funded; 290200600020I.
Citation: O'Connell J, Grau L, Goins T .
The costs of treating all-cause dementia among American Indians and Alaska native adults who access services through the Indian Health Service and Tribal health programs.
Alzheimers Dement 2022 Nov;18(11):2055-66. doi: 10.1002/alz.12603..
Keywords: Dementia, Racial and Ethnic Minorities, Healthcare Costs, Disparities
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Hua CL, Thomas KS, Bunker JN
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
This retrospective cohort study examined the association between a dementia diagnosis listed on a hospital claim and patient outcomes among individuals with a Minimum Data Set (MDS) assessment. The cohort was comprised of hospitalized patients aged 66 years and older with advanced dementia noted on an MDS assessment completed within 120 days prior to their first hospitalization in 2017. Among 120,989 patients with advanced dementia and a nursing home stay, 90.6% had a dementia diagnosis on their hospital claims. Documentation of a dementia diagnosis was associated with lower use of intensive care unit or coronary care unit, use of invasive mechanical ventilation, and 30-day mortality. These patients also had a shorter hospital length of stay.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker JN .
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
J Am Geriatr Soc 2022 Mar;70(3):846-53. doi: 10.1111/jgs.17564..
Keywords: Dementia, Diagnostic Safety and Quality, Medicare, Hospitals, Neurological Disorders
Lee W, Gray SL, Zaslavsky O
Association between having a family member with dementia and perceptions of dementia preventability.
This study examined how having a family history of dementia and caregiving experience are associated with perceptions about and self-efficacy for dementia preventability. Participants were surveyed whether they had a family member with dementia, and if they need whether they served as a caregiver. Of 1,575 respondents, 71% had a family member with dementia, and of those 42% served as a caregiver. People with a family member with dementia were less likely to believe that dementia is preventable and had lower self-efficacy for dementia prevention. Survey participants who were also caregivers had an even lower perception about dementia preventability.
AHRQ-funded; HS022982.
Citation: Lee W, Gray SL, Zaslavsky O .
Association between having a family member with dementia and perceptions of dementia preventability.
Aging Ment Health 2022 Feb;26(2):270-76. doi: 10.1080/13607863.2020.1839866..
Keywords: Dementia, Caregiving, Family Health and History, Prevention, Neurological Disorders
Rosenthal M, Poling J, Wec A
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
This article investigated health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes and its companion coalitions. These programs were introduced in 2012 for the purpose of encouraging reductions in antipsychotic use and increasing use of nonpharmacological treatments for dementia. Interviews were conducted with 40 nursing home physicians and staff in seven states. The authors found that reducing antipsychotics is more time and resource-intensive than relying on medication. However, respondents supported reductions in antipsychotic use. They indicated that with supported staffing, effective communications, and training, they could create or implement individualized treatments.
AHRQ-funded; HS023464.
Citation: Rosenthal M, Poling J, Wec A .
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
J Appl Gerontol 2022 Jan;41(1):62-72. doi: 10.1177/0733464820958919..
Keywords: Elderly, Medication, Nursing Homes, Dementia, Neurological Disorders, Long-Term Care, Shared Decision Making
Jutkowitz E, Kane RL, Gaugler JE
Societal and family lifetime cost of dementia: implications for policy.
This study estimated the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia. It found that the discounted total lifetime cost of care for a person with dementia was $321,780. Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kane RL, Gaugler JE .
Societal and family lifetime cost of dementia: implications for policy.
J Am Geriatr Soc 2017 Oct;85(10):2169-75. doi: 10.1111/jgs.15043.
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Keywords: Healthcare Costs, Dementia, Elderly, Caregiving
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention
Mehta HB, Mehta V, Goodwin JS
Association of hypoglycemia with subsequent dementia in older patients with type 2 diabetes mellitus.
This study evaluated an association of hypoglycemia with subsequent dementia in patients with type 2 diabetes. Hypoglycemia is associated with a higher risk of dementia and may be responsible in part for the higher risk of dementia in patients with diabetes. Alternatively, hypoglycemia may be a marker for undiagnosed cognitive impairment, and we cannot rule out the possibility of reverse causation between hypoglycemia and dementia.
AHRQ-funded; HS022134.
Citation: Mehta HB, Mehta V, Goodwin JS .
Association of hypoglycemia with subsequent dementia in older patients with type 2 diabetes mellitus.
J Gerontol A Biol Sci Med Sci 2017 Aug;72(8):1110-16. doi: 10.1093/gerona/glw217.
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Keywords: Dementia, Diabetes, Elderly, Risk
Jutkowitz E, Kuntz KM, Dowd B
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
This study used cross-sectional data (Aging, Demographics, and Memory Study) to estimate probabilities of experiencing outcomes by clinical features. It found that no clinical feature predicted the probability of having out-of-pocket medical expenditures. For those with medical expenditures, higher cognition and poorer function were associated with more spending.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, Kuntz KM, Dowd B .
Effects of cognition, function, and behavioral and psychological symptoms on out-of-pocket medical and nursing home expenditures and time spent caregiving for persons with dementia.
Alzheimers Dement 2017 Jul;13(7):801-09. doi: 10.1016/j.jalz.2016.12.011.
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Keywords: Caregiving, Dementia, Elderly, Healthcare Costs, Long-Term Care, Neurological Disorders, Nursing Homes
Jutkowitz E, MacLehose RF, Gaugler JE
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
This study examined the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Sociodemographic characteristics and clinical comorbidities predicted cognitive and functional changes. Only cognitive status explained behavioral decline.
AHRQ-funded; HS024165.
Citation: Jutkowitz E, MacLehose RF, Gaugler JE .
Risk factors associated with cognitive, functional, and behavioral trajectories of newly diagnosed dementia patients.
J Gerontol A Biol Sci Med Sci 2017 Feb;72(2):251-58. doi: 10.1093/gerona/glw079.
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Keywords: Dementia, Elderly, Behavioral Health, Neurological Disorders, Risk, Social Determinants of Health
Sarkar U, Lyles C, Steinman M
Changes in medication use after dementia diagnosis in an observational cohort of individuals with diabetes mellitus.
The researchers assessed changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. After adjustment, the number of chronic medications and the subset of cardiovascular medications declined after a dementia diagnosis in the overall cohort and in age-, sex-, and time-matched reference individuals, but the decline was significantly greater in the group with dementia.
AHRQ-funded; HS023558.
Citation: Sarkar U, Lyles C, Steinman M .
Changes in medication use after dementia diagnosis in an observational cohort of individuals with diabetes mellitus.
J Am Geriatr Soc 2017 Jan;65(1):77-82. doi: 10.1111/jgs.14429.
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Keywords: Medication, Diabetes, Dementia, Elderly, Healthcare Utilization
Gaugler JE, Jutkowitz E, Shippee TP
Consistency of dementia caregiver intervention classification: an evidence-based synthesis.
The objective of this review was to systematically examine inconsistencies in how dementia caregiver interventions are classified. When subjecting the classification of interventions to descriptive empirical analysis, extensive inconsistency was apparent. The authors concluded that substantial inconsistency in how dementia caregiver interventions are classified across systematic reviews has hindered the science and practice of dementia caregiver interventions.
AHRQ-funded; HS022445.
Citation: Gaugler JE, Jutkowitz E, Shippee TP .
Consistency of dementia caregiver intervention classification: an evidence-based synthesis.
Int Psychogeriatr 2017 Jan;29(1):19-30. doi: 10.1017/s1041610216001514.
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Keywords: Caregiving, Dementia, Evidence-Based Practice
Tjia J, Lemay CA, Bonner A
Informed family member involvement to improve the quality of dementia care in nursing homes.
Researchers described the extent to which nursing homes engaged families in antipsychotic initiation decisions in the year before surveyor guidance revisions were implemented. Under existing federal regulations but before guidance revisions were implemented in 2013, more than 40 percent of families reported being involved in nonpharmacological behavior management of family members, but fewer than one in four reported being involved throughout the entire antipsychotic prescribing process.
AHRQ-funded; HS019351.
Citation: Tjia J, Lemay CA, Bonner A .
Informed family member involvement to improve the quality of dementia care in nursing homes.
J Am Geriatr Soc 2017 Jan;65(1):59-65. doi: 10.1111/jgs.14299.
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Keywords: Shared Decision Making, Dementia, Medication, Nursing Homes, Patient and Family Engagement