Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries
Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries
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DOI：
10.1016/j.dadm.2018.12.005
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发表时间：
2019-12-01
影响因子：
5.3
通讯作者：
Andrews, J. Scott
中科院分区：
文献类型：
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作者：
Desai, Urvi;Kirson, Noam Y.;Andrews, J. Scott
这项研究评估了阿尔茨海默病(AD)确诊前3年的全因急诊科就诊、全因住院、潜在可避免的住院和跌倒的比率。方法从Medicare索赔数据中确定AD患者和没有认知障碍的对照组。患者被要求年龄=65岁，并在索引日期之前连续4年参加医疗保险(AD队列：2012-2014年首次诊断为AD；对照：随机选择的医疗索赔)。结果每年，在指数之前，AD患者比匹配的对照组(N=19,679对)更有可能有各种原因的急诊科就诊、各种原因的住院、潜在的可避免的住院和跌倒(P<；0.05用于所有比较)。随着时间的推移，所有结果的绝对和相对风险都在增加。讨论：这项研究结果强调了AD诊断前疾病负担的增加，并强调了及时认识和管理AD患者的必要性。
Introduction This study evaluates rates of all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis.Methods Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged >= 65 years and have continuous Medicare enrollment for >= 4 years before the index date (AD cohort: first AD diagnosis in 2012-2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score-matched cohorts.ResultsEach year, before index, patients with AD were more likely to have all-cause emergency department visits, all-cause hospitalizations, potentially avoidable hospitalizations, and falls (P < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes.Discussion The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.