Evidence map›Paper›PMID 38546202›Full record

ArticleJournal of the American Geriatrics Society2024

Trends in observation stays for Medicare beneficiaries with and without Alzheimer's disease and related dementias.

Laura G Burke, Ryan C Burke, Ciara E Duggan, Jose F Figueroa, Marie Boltz, Donna M Fick, E John Orav, Edward R Marcantonio

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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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

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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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

8 authors.

Laura G BurkeDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Ryan C BurkeDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
Ciara E DugganDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Jose F FigueroaDepartment of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Marie BoltzThe Pennsylvania State University College of Nursing, University Park, Pennsylvania, USA.ORCID 0000-0003-1133-2249
Donna M FickThe Pennsylvania State University College of Nursing, University Park, Pennsylvania, USA.ORCID 0000-0002-6777-1913
E John OravDivision of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Edward R MarcantonioDivisions of General Medicine and Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts, USA.

Funding

A National Analysis of Observation Care Among Medicare Beneficiaries with Alzheimer's Disease and Related DementiasR56AG075017 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI BURKE, LAURA G · 2022 to 2022
$779k
NIA NIH HHS R56 AG075017NIA NIH HHS R56AG075017
6 · The paper itself

Abstract

backgroundThere has been a marked rise in the use of observation care for Medicare beneficiaries visiting the emergency department (ED) in recent years. Whether trends in observation use differ for people with Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) is unknown.

methodsUsing a national 20% sample of Medicare beneficiaries ages 68+ from 2012 to 2018, we compared trends in ED visits and observation stays by AD/ADRD status for beneficiaries visiting the ED. We then examined the degree to which trends differed by nursing home (NH) residency status, assigning beneficiaries to four groups: AD/ADRD residing in NH (AD/ADRD+ NH+), AD/ADRD not residing in NH (AD/ADRD+ NH-), no AD/ADRD residing in NH (AD/ADRD- NH+), and no AD/ADRD not residing in NH (AD/ADRD- NH-).

resultsOf 7,489,780 unique beneficiaries, 18.6% had an AD/ADRD diagnosis. Beneficiaries with AD/ADRD had more than double the number of ED visits per 1000 in all years compared to those without AD/ADRD and saw a faster adjusted increase over time (+26.7 vs. +8.2 visits/year; p < 0.001 for interaction). The annual increase in the adjusted proportion of ED visits ending in observation was also greater among people with AD/ADRD (+0.78%/year, 95% CI 0.77-0.80%) compared to those without AD/ADRD (+0.63%/year, 95% CI 0.59-0.66%; p < 0.001 for interaction). Observation utilization was greatest for the AD/ADRD+ NH+ population and lowest for the AD/ADRD- NH- population, but the AD/ADRD+ NH- group saw the greatest increase in observation stays over time (+15.4 stays per 1000 people per year, 95% CI 15.0-15.7).

conclusionsMedicare beneficiaries with AD/ADRD have seen a disproportionate increase in observation utilization in recent years, driven by both an increase in ED visits and an increase in the proportion of ED visits ending in observation.

Indexed as

Alzheimer DiseaseEmergency Service, HospitalMedicareNursing HomesAgedAged, 80 and overDementiaFemaleHospitalizationHumansMaleUnited StatesAlzheimer's diseasedementiaemergency medicineMedicareobservation

Identifiers

PMID38546202
PMCPMC11090746

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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.