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

Affiliations

¹ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.
² Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
⁴ Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
⁵ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
⁶ Division of Geriatrics, Department of Internal Medicine, Home Instead Center for Successful Aging, University of Nebraska Medical Center, Omaha, NE, USA.
⁷ Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA.
⁸ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA. Electronic address: katherine.possin@ucsf.edu.

PMID: 31175026
PMCID: PMC7183386
DOI: 10.1016/j.jalz.2019.03.015

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

Yingjia Chen et al. Alzheimers Dement. 2019 Jul.

. 2019 Jul;15(7):899-906.

doi: 10.1016/j.jalz.2019.03.015. Epub 2019 Jun 4.

Authors

Affiliations

¹ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.
² Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
⁴ Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
⁵ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
⁶ Division of Geriatrics, Department of Internal Medicine, Home Instead Center for Successful Aging, University of Nebraska Medical Center, Omaha, NE, USA.
⁷ Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA.
⁸ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA. Electronic address: katherine.possin@ucsf.edu.

PMID: 31175026
PMCID: PMC7183386
DOI: 10.1016/j.jalz.2019.03.015

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.

PubMed Disclaimer

Conflict of interest statement

Declarations of interest: none.

References

1. American Psychiatric Association . Diagnostic and statistical manual of mental disorders 5th ed. American Psychiatric Publishing; 2013.
1. Alzheimer’s A 2016 Alzheimer’s disease facts and figures. Alzheimers Dement. 2016;12(4):459–509. - PubMed
1. Hurd MD, Martorell P, Delavande A, Mullen KJ, Langa KM. Monetary costs of dementia in the United States. N Engl J Med. 2013;368(14):1326–34. - PMC - PubMed
1. Census Bureau US. Choice: Current Reviews for Academic Libraries. 2012;49(6):1046-.
1. Grinberg LT, Nitrini R, Suemoto CK, Lucena Ferretti-Rebustini RE, Leite RE, Farfel JM, et al. Prevalence of dementia subtypes in a developing country: a clinicopathological study. Clinics (Sao Paulo). 2013;68(8):1140–5. - PMC - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical