Evidence map›Paper›PMID 34718569›Full record

ArticleThe Gerontologist2022

Out-of-Pocket Health Expenditures and Health Care Services Use Among Older Americans With Cognitive Impairment: Results From the 2008-2016 Health and Retirement Study.

Derek Jenkins, Ariana Stickel, Hector M González, Wassim Tarraf

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Gerontologist, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Determinants of Out-of-Pocket Health Spending in Households in Peru in the Times of the Pandemic (COVID-19).International journal of environmental research and public health · 2023
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Derek JenkinsInstitute of Gerontology, Wayne State University, Detroit, Michigan, USA.
Ariana StickelDepartment of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego School of Medicine, San Diego, California, USA.
Hector M GonzálezDepartment of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego School of Medicine, San Diego, California, USA.
Wassim TarrafInstitute of Gerontology, Wayne State University, Detroit, Michigan, USA.
University of California, San Diego · USWayne State University · US

Funding

San Diego Resource Center for advancing Alzheimer's Research in Minority Seniors (ARMS)P30AG059299 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI JOHN P. ELDER, PAUL E GILBERT · 2018 to 2026
$7.4M
Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA)R01AG048642 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GONZALEZ, HECTOR M · 2015 to 2019
$5.7M
UCSD Leading the Advancement of Underrepresented Neuroscientists for Change (LAUNCH) Faculty Development ProgramR25NS117367 · NINDS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Victoria B Risbrough, Joann Trejo · 2020 to 2026
$1.6M
NIA NIH HHS P30 AG059299NIH HHS R01AG048642NINDS NIH HHS R25 NS117367
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe evidence base on health services use and cost burdens associated with transition to severe cognitive impairment (SCI) and dementia is underdeveloped. We examine how the change in cognitive impairment status influences nursing home use, hospitalizations, and out-of-pocket (OOP) expenditures. RESEARCH DESIGN AND

methodsWe use prospective data from the Health and Retirement Study (2007/2008-2015/2016) on adults 70 years and older meeting research criteria for cognitive impairment not dementia (CIND) at baseline (unweighted n = 1,692) to fit 2-part models testing how reversion to normal cognition, stability (CIND maintenance), and transition into SCI/dementia influence change in yearly nursing home use, hospitalizations, and OOP expenditures.

resultsOver 8 years, 5.9% reverted, 15.9% remained CIND, 14.9% transitioned to SCI/dementia, and 63.3% died. We observed substantial increases in the propensity of any nursing home use which were particularly pronounced among those who transitioned or died during follow-up and similar but less pronounced differences in patterns of inpatient hospitalizations. Average baseline OOP spending was similar among reverters ($1156 [95% confidence interval = 832-1,479]), maintainers ($1,145 [993-1,296]), and transitioners ($1,385 [1,041-1,730]). Individuals who died during follow-up spent $2,529 (2,101-2,957). By the eighth year of follow-up, spending among reverters increased to $1,402 (869-1,934) and $2,188 (1,402-2,974) and $8,988 (5,820-12,157) for maintainers and transitioners, respectively. Average spending at the wave preceding death was $7,719 (4,345-11,094). Estimates were only partly attenuated through adjustment to covariables. DISCUSSION AND IMPLICATIONS: A better understanding of variations in health services use and cost burdens among individuals with mild cognitive impairment can help guide targeted care and financial planning.

Indexed as

Cognitive DysfunctionHealth ExpendituresAgedHospitalizationHumansProspective StudiesRetirementUnited StatesCognitive agingDementiaHealth services useOut-of-pocket spending

Identifiers

PMID34718569
PMCPMC9290880
OpenAlexW3210837053

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.