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Dementia may have an uneven effect on hospital use

By Allison Bell

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Having Alzheimer’s or other forms of dementia may affect the likelihood that some people will go to the hospital more than others.

Zhanlian Feng and other researchers at RTI International have presented that finding in a report distributed by the federal Office of Disability, Aging and Long-Term Care Policy.

The office is part of the U.S. Department of Health and Human Services.

The researchers used Medicare claims data and federal health survey data to look at how cognitive impairment affected the risk that Medicare enrollees would go to the hospital in a given year.

The researchers looked at people with and without cognitive impairment who lived either in nursing homes or out in the community. The researchers adjusted results for those people for many other variables, such as race, sex and income, and they also conducted a similar analysis for Medicare enrollees who were in their last year of life.

Medicare enrollees who were already in nursing homes went to the hospital often, and they were about as likely to go to the hospital whether they had cognitive impairment or not.

Similarly, all Medicare enrollees who were in their last year of life were likely to spend some time in the hospital. Dying Medicare enrollees who had cognitive impairment seem to have been somewhat less likely to go to the hospital than other dying enrollees.

The researchers found the biggest, most obvious effect of cognitive impairment on Medicare enrollees who still live at home.

For enrollees who were still living at home, having cognitive impairment seemed to increase the odds that they’d go to the hospital for any reason about 50 percent, and it seemed to increase the adds that they would go to the hospital for what the researchers defined as “potentially avoidable” reasons by about 75 percent.

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