Prevalence and predictors of incident ADRD diagnosis following a Medicare home health episode.
Prevalence and predictors of incident ADRD diagnosis following a Medicare home health episode.
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Medicare 家庭健康事件后 ADRD 诊断事件的患病率和预测因素。
DOI：
10.1002/alz.13061
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Ryvicker,Miriam
中科院分区：
文献类型：
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作者：
Burgdorf,JuliaG;Mroz,TracyM;Reckrey,JenniferM;Barrón,Yolanda;Ryvicker,Miriam
引言家庭健康（HH）可能是早期/未诊断的阿尔茨海默病和相关痴呆（ADRD）患者的重要护理来源，但对HH后ADRD诊断的患病率或预测因素知之甚少。方法使用2010-2012年链接的主受益人摘要文件（MBSF）和40，596名医疗保健HH患者的HH评估数据，我们通过多变量逻辑回归分析建立了HH后1年内ADRD诊断的模型。2在未诊断为ADRD的HH患者中，10%的患者在1年内接受了ADRD诊断。在调整后的模型中，如果患者患有HH临床医生报告的整体认知受损，则其接受ADRD诊断的可能性增加3倍（与未报告损伤的患者相比），如果他们是社区转诊的患者，（与医院转诊患者相比）迫切需要制定量身定制的HH临床路径，并保护社区推荐的HH的可及性，以支持社区生活的老年人，未确诊的ADRD
INTRODUCTIONHome health (HH) may be an important source of care for those with early‐stage/undiagnosed Alzheimer's Disease and Related Dementias (ADRD), but little is known regarding prevalence or predictors of incident ADRD diagnosis following HH.METHODSUsing 2010–2012 linked Master Beneficiary Summary File (MBSF) and HH assessment data for 40,596 Medicare HH patients, we model incident ADRD diagnosis within 1 year of HH via multivariable logistic regression.RESULTSAmong HH patients without diagnosed ADRD, 10% received an incident diagnosis within 1 year. In adjusted models, patients were three times more likely to receive an incident ADRD diagnosis if they had HH clinician‐reported impaired overall cognition (compared to patients without reported impairment) and twice as likely if they were community‐referred (compared to hospital‐referred patients).DISCUSSIONThere is a pressing need to develop tailored HH clinical pathways and protect access to community‐referred HH to support community‐living older adults with early‐stage/undiagnosed ADRD.