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Healthcare utilization of Mexican-American Medicare beneficiaries with and without Alzheimer's disease and related dementias.
PLOS ONE ( IF 2.9 ) Pub Date : 2020-01-15 , DOI: 10.1371/journal.pone.0227681 Brian Downer 1, 2 , Soham Al Snih 1, 2 , Mukaila Raji 2, 3 , Lin-Na Chou 4 , Yong-Fang Kuo 2, 4 , Kyriakos S Markides 2, 5 , Kenneth J Ottenbacher 1, 2
PLOS ONE ( IF 2.9 ) Pub Date : 2020-01-15 , DOI: 10.1371/journal.pone.0227681 Brian Downer 1, 2 , Soham Al Snih 1, 2 , Mukaila Raji 2, 3 , Lin-Na Chou 4 , Yong-Fang Kuo 2, 4 , Kyriakos S Markides 2, 5 , Kenneth J Ottenbacher 1, 2
Affiliation
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BACKGROUND
Older adults with Alzheimer's disease and related dementias (ADRD) are high-risk to experience hospitalizations and emergency room (ER) admissions. Mexican-Americans have a high prevalence of ADRD, but there is limited information on the healthcare use of older Mexican-Americans with ADRD. We used data from a cohort of older Mexican-Americans that has been linked with Medicare files to investigate differences in hospitalizations, ER admissions, and physician visits according to ADRD diagnosis. We also identify sociodemographic, health, and functional characteristics that may contribute to differences in healthcare utilization between Mexican-American Medicare beneficiaries with and without an ADRD diagnosis.
METHODS AND FINDINGS
Data came from the Hispanic Established Populations for the Epidemiological Study of the Elderly that has been linked with Medicare Master Beneficiary Summary Files, Medicare Provider Analysis and Review files, Outpatient Standard Analytic files, and Carrier files. The final analytic sample included 1048 participants. Participants were followed for two years (eight quarters) after their survey interview. Generalized estimating equations were used to estimate the probability for one or more hospitalizations, ER admissions, and physician visits at each quarter. ADRD was associated with higher odds for hospitalizations (OR = 1.65, 95%CI = 1.29-2.11) and ER admissions (OR = 1.57, 95%CI = 1.23-1.94) but not physician visits (OR = 1.23, 95%CI = 0.91-1.67). The odds for hospitalizations (OR = 1.24, 95%CI = 0.97-1.60) and ER admissions (OR = 1.27, 95%CI = 1.01-1.59) were reduced after controlling for limitations in activities of daily living and comorbidities.
CONCLUSIONS
Mexican-American Medicare beneficiaries with ADRD had significantly higher odds for one or more hospitalizations and ER admissions but similar physician visits compared to beneficiaries without ADRD. Functional limitations and comorbidities contributed to the higher hospitalizations and ER admissions for older Mexican-Americans with ADRD.
中文翻译：
患有和不患有阿尔茨海默氏病和相关痴呆症的墨西哥裔美国人医疗保险受益人的医疗保健利用情况。
背景技术患有阿尔茨海默氏病和相关痴呆症（ADRD）的老年人患住院和急诊室（ER）的风险很高。墨西哥裔美国人的ADRD患病率很高，但是关于老年墨西哥裔美国人使用ADRD的医疗保健信息却很少。我们使用了来自墨西哥裔美国人队列的数据，该数据已与Medicare文件相关联，以根据ADRD诊断调查住院，急诊入院和就诊次数之间的差异。我们还确定了社会人口统计学，健康状况和功能特征，这些特征可能会导致墨西哥裔美国人医疗保险受益人（无论是否患有ADRD诊断）之间在医疗保健利用方面的差异。方法和结果数据来自西班牙裔老年人流行病学研究既定人群，该人口与Medicare主受益人摘要文件，Medicare提供者分析和审查文件，门诊标准分析文件和承运人文件相关联。最终的分析样本包括1048名参与者。参加调查的受访者被跟踪了两年（八分之四）。广义估计方程用于估计每个季度一次或多次住院，急诊入院和就诊的可能性。ADRD与住院几率较高（OR = 1.65，95％CI = 1.29-2.11）和ER入院（OR = 1.57，95％CI = 1.23-1.94）相关，而与医生就诊率无关（OR = 1.23，95％CI = 0.91-1.67）。住院几率（OR = 1.24，95％CI = 0.97-1。在控制了日常生活活动和合并症的限制后，ER入院率（OR = 1.27，95％CI = 1.01-1.59）降低了。结论与没有ADRD的受益人相比，患有ADRD的墨西哥裔美国人医疗保险受益人一次或多次住院和ER入院的几率高得多，但就诊次数相近。功能上的局限性和合并症促使墨西哥裔美国人患有ADRD的住院率和急诊率更高。
更新日期：2020-01-16
中文翻译：
患有和不患有阿尔茨海默氏病和相关痴呆症的墨西哥裔美国人医疗保险受益人的医疗保健利用情况。
背景技术患有阿尔茨海默氏病和相关痴呆症（ADRD）的老年人患住院和急诊室（ER）的风险很高。墨西哥裔美国人的ADRD患病率很高，但是关于老年墨西哥裔美国人使用ADRD的医疗保健信息却很少。我们使用了来自墨西哥裔美国人队列的数据，该数据已与Medicare文件相关联，以根据ADRD诊断调查住院，急诊入院和就诊次数之间的差异。我们还确定了社会人口统计学，健康状况和功能特征，这些特征可能会导致墨西哥裔美国人医疗保险受益人（无论是否患有ADRD诊断）之间在医疗保健利用方面的差异。方法和结果数据来自西班牙裔老年人流行病学研究既定人群，该人口与Medicare主受益人摘要文件，Medicare提供者分析和审查文件，门诊标准分析文件和承运人文件相关联。最终的分析样本包括1048名参与者。参加调查的受访者被跟踪了两年（八分之四）。广义估计方程用于估计每个季度一次或多次住院，急诊入院和就诊的可能性。ADRD与住院几率较高（OR = 1.65，95％CI = 1.29-2.11）和ER入院（OR = 1.57，95％CI = 1.23-1.94）相关，而与医生就诊率无关（OR = 1.23，95％CI = 0.91-1.67）。住院几率（OR = 1.24，95％CI = 0.97-1。在控制了日常生活活动和合并症的限制后，ER入院率（OR = 1.27，95％CI = 1.01-1.59）降低了。结论与没有ADRD的受益人相比，患有ADRD的墨西哥裔美国人医疗保险受益人一次或多次住院和ER入院的几率高得多，但就诊次数相近。功能上的局限性和合并症促使墨西哥裔美国人患有ADRD的住院率和急诊率更高。
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