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Alzheimers Dement. 2019 Jul;15(7):899-906. doi: 10.1016/j.jalz.2019.03.015. Epub 2019 Jun 4.

The costs of dementia subtypes to California Medicare fee-for-service, 2015.

Author information

1
Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.
2
Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
3
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
4
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
5
Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
6
Division of Geriatrics, Department of Internal Medicine, Home Instead Center for Successful Aging, University of Nebraska Medical Center, Omaha, NE, USA.
7
Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA.
8
Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA; Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA. Electronic address: katherine.possin@ucsf.edu.

Abstract

INTRODUCTION:

Dementia is among the costliest of medical conditions, but it is not known how these costs vary by dementia subtype.

METHODS:

The effect of dementia diagnosis subtype on direct health care costs and utilization was estimated using 2015 California Medicare fee-for-service data. Potential drivers of increased costs in Lewy body dementia (LBD), in comparison to Alzheimer's disease, were tested.

RESULTS:

3,001,987 Medicare beneficiaries were identified, of which 8.2% had a dementia diagnosis. Unspecified dementia was the most common diagnostic category (59.6%), followed by Alzheimer's disease (23.2%). LBD was the costliest subtype to Medicare, on average, followed by vascular dementia. The higher costs in LBD were explained in part by falls, urinary incontinence or infection, depression, anxiety, dehydration, and delirium.

DISCUSSION:

Dementia subtype is an important predictor of health care costs. Earlier identification and targeted treatment might mitigate the costs associated with co-occurring conditions in LBD.

KEYWORDS:

Alzheimer's disease; Falls; Health care costs; Lewy body dementia; Medicare; Vascular dementia

PMID:
31175026
DOI:
10.1016/j.jalz.2019.03.015

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