Evidence map›Paper›PMID 40481707›Full record

Observational studyJournal of the American Geriatrics Society2025

Ambulatory Care Sensitive Hospitalizations and Disparities Among Older Adults With Dementia Before and During the Pandemic.

Shubing Cai, Qiuyuan Qin, Peter Veazie, Yeates Conwell, Helena Temkin-Greener

Abstract readObservational Study
In one paragraph

Observational study in Journal of the American Geriatrics Society, 2025. 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. 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

5 authors.

Shubing CaiDepartment of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
Qiuyuan QinDepartment of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.ORCID 0000-0002-5587-9177
Peter VeazieDepartment of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
Yeates ConwellDepartment of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
Helena Temkin-GreenerDepartment of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.ORCID 0000-0001-6113-2953

Funding

The impact of COVID-19 pandemic on community-dwelling older adults with ADRDRF1AG063811 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2019 to 2020
$2.2M
Telemedicine and health disparities among community-dwelling older adults with ADRD during COVID-19 pandemicRF1AG073052 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2021 to 2021
$1.4M
Telemedicine and health disparities among community-dwelling older adults with ADRD during COVID-19 pandemicR01AG073052 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2024 to 2024
$245k
NIA NIH HHS R01 AG073052NIA NIH HHS R01/RF1AG073052NIA NIH HHS RF1 AG063811NIA NIH HHS RF1AG063811NIA NIH HHS RF1 AG073052
6 · The paper itself

Abstract

backgroundOlder adults with Alzheimer's disease and related dementias (ADRD) are frequently hospitalized with ambulatory care-sensitive conditions (ACSCs). Disparities in ACSC hospitalizations have been documented, but the impact of the COVID-19 pandemic on ACSC hospitalizations and disparities of older adults with ADRD is unclear, particularly, across different racial, ethnic, and socioeconomic groups. This study examined changes in ACSC hospitalizations among community-dwelling older adults with ADRD before and during the pandemic and how these changes vary by race, ethnicity, and Medicare-Medicaid dual eligibility status.

methodsThis observational study linked Medicare data with publicly available sources. The study sample included Medicare fee-for-service community-dwelling older adults aged 65 and older with ADRD in 2019 or 2021. The primary outcome was whether an individual had any ACSC hospitalizations in a given year (0/1). Secondary outcomes included any non-COVID-19-related hospitalizations and death (0/1). We used linear probability models with zip-code random effects, accounting for individual and community characteristics.

resultsThe study included 2.35 million beneficiaries in 2019 and 1.85 million in 2021. Non-COVID-19-related hospitalizations decreased from 24.0% in 2019 to 20.4% in 2021, while ACSC hospitalizations fell from 23.0% to 19.0% among those who were hospitalized. In 2019, Black and Hispanic individuals had 2.0 and 1.6 percentage points higher probabilities of ACSC hospitalization (p < 0.001), respectively, compared to White individuals, and dual-eligibles had a 2.8 percentage-point higher probability than non-dual-eligibles (p < 0.001). During the pandemic, overall hospitalizations and ACSC hospitalizations decreased, with dual-eligibles experiencing an additional 2.1 percentage-point reduction in ACSC hospitalizations(p < 0.001). Meanwhile, dual-eligibles experienced a 1.5 percentage-point increase in mortality rate in 2021 compared to 2019 (p < 0.001).

conclusionRacial and ethnic minorities and the socioeconomically disadvantaged older adults with ADRD were more likely to experience ACSC hospitalizations compared to their counterparts before the pandemic.

Indexed as

Ambulatory CareCOVID-19DementiaHealthcare DisparitiesHospitalizationAgedAged, 80 and overFemaleHumansIndependent LivingMaleMedicaidMedicarePandemicsSARS-CoV-2United StatesACSC hospitalizationdementiapandemic

Identifiers

PMID40481707
PMCPMC12226735

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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.