ArticleBMC health services research2014
Using U.S. Medicare records to evaluate the indirect health effects on spouses: a case study in Alzheimer's disease patients.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 25 citations in OpenAlex.
- Impact of the REACH II and REACH VA Dementia Caregiver Interventions on Healthcare Costs.Journal of the American Geriatrics Society · 2017Trial
- Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.JAMA network open · 2025Article
- Association between cognitive impairment and oral anticancer agent use in older patients with metastatic renal cell carcinoma.Journal of the American Geriatrics Society · 2022Article
- Measuring Frailty in Health Care Databases for Clinical Care and Research.Annals of geriatric medicine and research · 2020Review
- Using elastic nets to estimate frailty burden from routinely collected national aged care data.Journal of the American Medical Informatics Association : JAMIA · 2020Article
- Validation of a Claims-Based Frailty Index Against Physical Performance and Adverse Health Outcomes in the Health and Retirement Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2019Article
- Does Caregiving Strain Increase as Patients With and Without Dementia Approach the End of Life?Journal of pain and symptom management · 2019Article
- Validation of the JEN frailty index in the National Long-Term Care Survey community population: identifying functionally impaired older adults from claims data.BMC health services research · 2018Article
- Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index.The journals of gerontology. Series A, Biological sciences and medical sciences · 2018Article
- Dementia Caregivers' Use of Services for Themselves.The Gerontologist · 2016Article
- Assessing the economic burden of Alzheimer's disease patients first diagnosed by specialists.BMC geriatrics · 2016Article
- Major Cost Drivers in Assessing the Economic Burden of Alzheimer's Disease: A Structured, Rapid Review.The journal of prevention of Alzheimer's diseaseReview
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe burden experienced by spouses of patients with Alzheimer's disease (AD) may have negative consequences for their physical health. We describe here a method for analyzing United States Medicare records to determine the changes in health service use and costs experienced by spouses after their marital partner receives an AD diagnosis.
methodsWe initially identified all beneficiaries in the 2001-2005 Medicare 5% sample who had multiple claims listing the ICD-9 diagnostic code for AD, 331.0. The 5% sample includes spouses who share a Medicare account with their marital partners because they lack a sufficient work history for full eligibility on their own. A matched cohort study assessed incremental health costs in the spouses of AD patients versus a control group of spouses of non-AD patients. Longitudinal and cross-sectional analyses tracked the impact of a patient's AD diagnosis on his or her spouse's healthcare costs.
resultsOur method located 54,593 AD patients of whom 11.5% had spouses identifiable via a shared Medicare account. AD diagnosis in one member of a couple was associated with significantly higher monthly Medicare payments for the other member's healthcare. The spouses' elevated costs commenced 2 to 3 months before their partners' AD diagnosis and persisted over the follow-up period. After 31 months, the cumulative additional Medicare reimbursements totaled a mean $4,600 in the spouses of AD patients. This excess was significant even after accounting for differences in baseline health status between the cohorts.
conclusionThe study methodology provides a framework for comprehensively evaluating medical costs of both chronically ill patients and their spouses. This method also provides monthly data, which makes possible a longitudinal evaluation of the cost effects of specific health events. The observed correlations provide a coherent demonstration of the interdependence between AD patients' and spouses' health. Future research should examine caregiving burden and other possible factors contributing to the AD spouses' health outcomes. It should also extend the method presented here to evaluations of other chronic diseases of the elderly.
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