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Patients with Alzheimer's disease, dementia at increased risk for hospital readmissions

The rate of readmission among Rhode Island Medicare beneficiaries with Alzheimer’s disease or dementia was nearly 20% in 2009, according to data from researchers in Rhode Island.

“Persons with dementia may have difficulties comprehending and following important discharge instructions (eg, medication changes, decision making, self-care),” study author Lori Daiello, PharmD, of the Alzheimer’s Disease and Memory Disorders Center at Rhode Island Hospital, said in a press release. “In addition, many patients with dementia have multiple medical conditions, so it’s not surprising that this group of vulnerable older adults might be at a higher risk of being readmitted to the hospital shortly after discharge.”

Daiello and colleagues from Brown University and Rhode Island Hospital in Providence collected administrative claims data for 3,908 index hospitalizations in 2009 of Medicare fee-for-service beneficiaries with a diagnosis of Alzheimer’s disease or dementia. Conditional logistic regression models were used to calculate the odds for readmission to any US hospital within 30 days, factoring in demographics, degree of comorbid disease burden and other potential confounders.

According to data, within 30 days 5,133 hospital readmissions occurred, with an adjusted odds ratio for readmission of 1.18 (95% CI, 1.08-1.29) compared with those hospitalized without dementia. The association did not decrease after controlling for discharge site of care, researchers reported (adjusted OR=1.21; 95% CI, 1.10-1.33).

“Our results indicate that a diagnosis of dementia may be a marker of vulnerability for rapid re-hospitalization and may suggest a role for specialized initiatives aimed at lowering readmission rates,” Daiello said. “Developing effective interventions to prevent unnecessary readmissions is critically important because hospitalizations are often destabilizing events for persons with dementia and consequently place undue burden on our patients, their families and caregivers, and ultimately on our healthcare systems due to financial penalties and reduced Medicare reimbursements.”

Disclosures: Healio.com/Psychiatry could not confirm financial disclosures at the time of publication.