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Comorbidity management not optimal in many patients with Alzheimer's disease, related dementias

Patients with Alzheimer's disease or related dementias do not have other medical conditions managed adequately, according to data presented at the Alzheimer’s Association International Conference.

Pei-Jung Lin, PhD, from the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, and colleagues reported that this leads to poorer patient outcomes and higher health care costs.

Researchers used Medicare claims data to measure potentially avoidable hospitalization rates for Ambulatory Care Sensitive Conditions and associated Medicare expenditures. Their data included 2,749,172 fee-for-service beneficiaries aged at least 65 years who had a diagnosis of Alzheimer's disease or related dementias. They specifically assessed hospitalization rates for chronic conditions such as respiratory conditions, diabetes and cardiovascular diseases and acute conditions such as urinary tract infections, dehydration and bacterial pneumonia.

Results showed that 10% of participants had at least one potentially avoidable hospitalization in 2013, and 14% of hospital admissions among participants were due to a potentially avoidable condition.

Lin and colleagues identified 369,165 potentially avoidable hospitalizations, which totaled $2.58 billion in Medicare expenditures. Of these, 188,870 were for acute conditions, which accounted for 47% of costs and 180,307 were for chronic conditions, which accounted for 53% of costs.

In addition, both multiple chronic comorbidities and late-stage dementia were significantly associated with potentially avoidable hospitalizations.

"Our findings suggest that management of co-existing diseases remains suboptimal among many people with Alzheimer's or other dementias, especially those with advanced disease," Lin said in a press release. "In 2013, for example, more than 369,000 hospital stays and $2.58 billion in Medicare costs could have been prevented with better ambulatory care and effective treatment. Case management programs for people with Alzheimer's and other dementias should involve strategies to reduce avoidable hospitalizations in order to improve patient outcomes and lower costs." – by Chelsea Frajerman Pardes

Reference:

Lin PJ, et al. National estimates of potentially avoidable hospitalizations among Medicare beneficiaries with Alzheimer's disease and related dementias. Presented at: Alzheimer’s Association International Conference; July 24-28, 2016; Toronto.

Disclosures: Healio Internal Medicine could not confirm relevant financial disclosures at the time of publication.