The costs of dementia subtypes to California Medicare fee-for-service, 2015

Yingjia Chen; Leslie Wilson; John Kornak; R. Adams Dudley; Jennifer Merrilees; Stephen J. Bonasera; Christie M. Byrne; Kirby Lee; Winston Chiong; Bruce L. Miller; Katherine L. Possin

doi:10.1016/j.jalz.2019.03.015

The costs of dementia subtypes to California Medicare fee-for-service, 2015

Yingjia Chen, Leslie Wilson, John Kornak, R. Adams Dudley, Jennifer Merrilees, Stephen J. Bonasera, Christie M. Byrne, Kirby Lee, Winston Chiong, Bruce L. Miller, Katherine L. Possin

Pulmonary, Allergy, Critical Care and Sleep Medicine

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Introduction: Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype. Methods: The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested. Results: 3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium. Discussion: Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.

Original language	English (US)
Pages (from-to)	899-906
Number of pages	8
Journal	Alzheimer's and Dementia
Volume	15
Issue number	7
DOIs	https://doi.org/10.1016/j.jalz.2019.03.015
State	Published - Jul 2019

Bibliographical note

Funding Information:
This project was funded by the Global Brain Health Institute, the Department of Health and Human Services, Centers for Medicare & Medicaid Services (1C1CMS331346), the National Institute on Aging (5R01AG056715), and the National Institute on Neurological Disorders and Stroke (UG3 NS105557). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. None of the funding agencies were involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The authors are grateful to Sarah Dulaney and Michael Schaffer for their work on project operations and data management.

Funding Information:
This project was funded by the Global Brain Health Institute , the Department of Health and Human Services , Centers for Medicare & Medicaid Services ( 1C1CMS331346 ), the National Institute on Aging ( 5R01AG056715 ), and the National Institute on Neurological Disorders and Stroke ( UG3 NS105557 ). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. None of the funding agencies were involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The authors are grateful to Sarah Dulaney and Michael Schaffer for their work on project operations and data management.

Publisher Copyright:
© 2019

Keywords

Alzheimer's disease
Falls
Health care costs
Lewy body dementia
Medicare
Vascular dementia

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10.1016/j.jalz.2019.03.015

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title = "The costs of dementia subtypes to California Medicare fee-for-service, 2015",

abstract = "Introduction: Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype. Methods: The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested. Results: 3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium. Discussion: Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.",

keywords = "Alzheimer's disease, Falls, Health care costs, Lewy body dementia, Medicare, Vascular dementia",

author = "Yingjia Chen and Leslie Wilson and John Kornak and Dudley, {R. Adams} and Jennifer Merrilees and Bonasera, {Stephen J.} and Byrne, {Christie M.} and Kirby Lee and Winston Chiong and Miller, {Bruce L.} and Possin, {Katherine L.}",

note = "Funding Information: This project was funded by the Global Brain Health Institute, the Department of Health and Human Services, Centers for Medicare & Medicaid Services (1C1CMS331346), the National Institute on Aging (5R01AG056715), and the National Institute on Neurological Disorders and Stroke (UG3 NS105557). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. None of the funding agencies were involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The authors are grateful to Sarah Dulaney and Michael Schaffer for their work on project operations and data management. Funding Information: This project was funded by the Global Brain Health Institute , the Department of Health and Human Services , Centers for Medicare & Medicaid Services ( 1C1CMS331346 ), the National Institute on Aging ( 5R01AG056715 ), and the National Institute on Neurological Disorders and Stroke ( UG3 NS105557 ). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. None of the funding agencies were involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. The authors are grateful to Sarah Dulaney and Michael Schaffer for their work on project operations and data management. Publisher Copyright: {\textcopyright} 2019",

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AU - Merrilees, Jennifer

AU - Bonasera, Stephen J.

AU - Byrne, Christie M.

AU - Lee, Kirby

AU - Chiong, Winston

AU - Miller, Bruce L.

AU - Possin, Katherine L.

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N2 - Introduction: Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype. Methods: The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested. Results: 3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium. Discussion: Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.

AB - Introduction: Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype. Methods: The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested. Results: 3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium. Discussion: Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.

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The costs of dementia subtypes to California Medicare fee-for-service, 2015

Abstract

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