ArticleJournal of the American Geriatrics Society2023
Primary care patterns among dual eligibles with Alzheimer's disease and related dementias.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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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.
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.
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Who cites it
6 citing papers in PubMed.
- Days at Home Among Dually Eligible Medicare Beneficiaries With Alzheimer Disease and Related Dementias.JAMA network open · 2026Article
- Ambulatory care for individuals dually eligible for Medicare and Medicaid.Health affairs scholar · 2025Article
- Community detection and management of mild cognitive impairment in Shanghai: a mixed-methods study.Health policy and planning · 2025Article
- Prevalence of dementia diagnoses in a safety net health system.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Accountable care organizations and Medicare payments for residents with ADRD in disadvantaged neighborhoods.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Medicare Payments and ACOs for Dementia Patients Across Race and Social Vulnerability.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundPrimary care is essential for persons with Alzheimer's disease and related dementias (ADRD). Prior research suggests that the propensity to provide high-quality, continuous primary care varies by provider setting, but the settings used by Medicare-Medicaid dual-eligibles with ADRD have not been described at the population level.
methodsUsing 2012-2018 Medicare data, we identified dual-eligibles with ADRD. For each person-year, we identified primary care visits occurring in six settings. We calculated descriptive statistics for beneficiaries with a majority of visits in each setting, and conducted a k-means cluster analysis to determine utilization patterns, using the standardized count of primary care visits in each setting.
resultsEach year from 2012 to 2018, at least 45.6% of dual-eligibles with ADRD received a majority of their primary care in nursing facilities, while at least 25.2% did so in physician offices. Over time, the share relying on nursing facilities for primary care decreased by 5.2 percentage points, offset by growth in Federally Qualified Health Centers (FQHCs) and miscellaneous settings (2.3 percentage points each). Dual-eligibles relying on nursing facilities had more annual primary care visits (16.1) than those relying on other settings (range: 6.8-10.7 visits). Interpersonal care continuity was also higher in nursing facilities (97.0%) and physician offices (87.9%) than in FQHCs (54.2%), rural health clinics (RHCs, 46.6%), or hospital-based clinics (56.8%). Among dual-eligibles without care continuity, 82.7% were assigned to a cluster with few primary care visits.
conclusionsA trend toward care in different settings likely reflects improved access to patient-centered primary care. Low rates of interpersonal care continuity in FQHCs, RHCs, and physician offices may warrant concern, unless providers in these settings function as a care team. Nonetheless, every healthcare system encounter presents an opportunity to designate a primary care provider for dual-eligibles with ADRD who use little or no primary care.
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