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AHRQ Research Studies
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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 4 of 4 Research Studies Displayed
Anderson 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.
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
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.
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
Hua CL, Thomas KS, Bunker J
Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia.
The objective of this study was to examine the agreement between a clinical Minimum Data Set measure of dementia and a diagnosis of dementia documented on a hospital claim across three points in time. A second objective was to examine the extent to which the agreement varied by age, sex, and race/ethnicity. Findings showed that hospital claims for patients aged 66–75 were less likely to be accurate than those for other age groups and suggests that physicians do not always look for signs of dementia in younger adults. Additionally, Asian patients were less likely to have a diagnosis of dementia documented during hospitalization, which could be related to language barriers between patients and clinicians.
Citation: Hua CL, Thomas KS, Bunker J . Changes in the agreement between the Minimum Data Set and hospital Medicare claims measures of dementia. J Am Geriatr Soc 2021 Sep;69(9):2672-75. doi: 10.1111/jgs.17201..
Keywords: Elderly, Dementia, Neurological Disorders, Diagnostic Safety and Quality, Medicare
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
Citation: Roberts ET, McGarry BE, Glynn A . Cognition and take-up of the Medicare Savings Programs. JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords: Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders