Clinical Edge

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Health Care Utilization of a Dementia Care Program

JAMA Intern Med; ePub 2018 Dec 21; Jennings, et al

Comprehensive dementia care programs may help more patients stay in community-based settings, a recent study found. The case control study used a quasiexperimental design to compare health care utilization and costs for 1,083 Medicare fee-for-service beneficiaries enrolled in the University of California Los Angeles Health System Alzheimer and Dementia Care program between July 1, 2012 and December 31, 2015, with those of 2,166 similar patients with dementia not participating in the program. Patients in the dementia care program were comanaged by nurse practitioners and physicians. Primary outcomes included admissions to long-term care facilities, average difference-in-differences per quarter over the 3-year intervention period for all-cause hospitalization, emergency department (ED) visits, 30-day hospital readmissions, and total Medicare Parts A and B costs of care. Among the findings:

  • Program participants were less likely to be admitted to a long-term care facility vs those not participating in the dementia care program.
  • There were no differences between groups in terms of hospitalizations, ED visits, or 30-day readmissions.
  • Comprehensive dementia care may be cost neutral or cost saving.

Citation:

Jennings LA, Laffan AM, Schlissel AC, et al. Health care utilization and cost outcomes of a comprehensive dementia care program for Medicare beneficiaries. [Published online ahead of print December 21, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.5579.

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