Evidence map›Paper›PMID 37070972›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2023

Advanced practice clinician care and end-of-life outcomes for community- and nursing home-dwelling Medicare beneficiaries with dementia.

Hyesung Oh, Elizabeth M White, Ulrike Muench, Christopher Santostefano, Bishnu Thapa, Cyrus Kosar, Emily A Gadbois, Zainab Toteh Osakwe, Pedro Gozalo, Momotazur Rahman

Abstract read
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In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

10 authors.

Hyesung OhDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Elizabeth M WhiteDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Ulrike MuenchDepartment of Social and Behavioral Sciences, University of California San Francisco School of Nursing, San Francisco, California, USA.
Christopher SantostefanoDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Bishnu ThapaDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Cyrus KosarDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Emily A GadboisDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Zainab Toteh OsakweCollege of Nursing and Public Health, Adelphi University, Garden City, New York, USA.
Pedro GozaloDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Momotazur RahmanDepartment of Health Services, Policy & Practice, Brown University School of Public Health, Providence, Rhode Island, USA.

Funding

The Impact of Advanced Practice Clinicians on End of Life Outcomes for Older Adults with DementiaR01AG065312 · NIA · BROWN UNIVERSITY · PI RAHMAN, MD MOMOTAZUR · 2020 to 2022
$1.3M
NIA NIH HHS R01 AG065312
6 · The paper itself

Abstract

introductionOlder adults with Alzheimer's disease and related dementias (ADRD) often face burdensome end-of-life care transfers. Advanced practice clinicians (APCs)-which include nurse practitioners and physician assistants-increasingly provide primary care to this population. To fill current gaps in the literature, we measured the association between APC involvement in end-of-life care versus hospice utilization and hospitalization for older adults with ADRD.

methodsUsing Medicare data, we identified nursing home- (N=517,490) and community-dwelling (N=322,461) beneficiaries with ADRD who died between 2016 and 2018. We employed propensity score-weighted regression methods to examine the association between different levels of APC care during their final 9 months of life versus hospice utilization and hospitalization during their final month.

resultsFor both nursing home- and community-dwelling beneficiaries, higher APC care involvement associated with lower hospitalization rates and higher hospice rates. DISCUSSION: APCs are an important group of providers delivering end-of-life primary care to individuals with ADRD. HIGHLIGHTS: For both nursing home- and community-dwelling Medicare beneficiaries with ADRD, adjusted hospitalization rates were lower and hospice rates were higher for individuals with higher proportions of APC care involvement during their final 9 months of life. Associations between APC care involvement and both adjusted hospitalization rates and adjusted hospice rates persisted when accounting for primary care visit volume.

Indexed as

Alzheimer DiseaseMedicareAgedDeathHospitalizationHumansNursing HomesRetrospective StudiesUnited Statesadvanced practice cliniciansAlzheimer's disease and related dementiashospice utilizationhospital utilizationnurse practitionersnursing homephysician assistantsprimary care

Identifiers

PMID37070972
PMCPMC10523969

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Registered trials

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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.