New research published in Journal of the American Geriatric Society reveals that while older people with dementia have a higher risk of being hospitalized than those without cognitive impairment, many hospital stays could have been avoided with better outpatient care. Beth Israel Deaconess Medical Center (BIDMC) investigators say fewer people with dementia would be hospitalized if improvements were made.
“Care for the elderly with dementia is often incorrectly defined as a problem exclusively in a nursing home, but our study shows that over 80% of hospitalizations occur in the elderly living in the community,” said Dr. Timothy Anderson, lead author of the study and a general internist and health services researcher in the General Medicine Division of the BIDMC, in a press release. “Therefore, initiatives to reduce preventable hospitalizations must include outpatient care.”
The researchers studied data on national hospital discharge from 2012 to 2016 covering 1.8 million hospitalizations of older US adults 65 years of age or older with dementia. They found that even though general hospitalization had decreased among patients with dementia during that period, hospitalizations for potentially preventable conditions increased from 0.75 million to 0.87 million per year. The most common cause of hospitalizations in this population was pneumonia and heart failure along with sepsis, injury and dehydration.
Anderson, also a medical instructor at Harvard Medical School, says previous detection and treatment strategies to address physical health among the elderly with dementia should be prioritized.
“These preventable hospitalizations have important effects that extend beyond hospital stay, both in terms of patient outcomes – since most are discharged to qualified nursing facilities rather than returning home – and in terms of costs for the healthcare system. “Anderson said.
For example, 86% of hospitalized patients were hospitalized by the community, but only 33% were discharged from the community. In addition, among patients with dementia hospitalized for potentially preventable conditions, deaths between hospitalized patients decreased from 6.4 percent to 6.1 percent. However, median inflation adjusted costs increased from $ 7,319 to $ 7,543 and total annual costs increased from $ 7.4 billion to $ 9.3 billion.
These findings go hand in hand with other reports, including that of the Blue Cross Blue Shield Association which shows that early-onset dementia is on the rise. According to that report, the number of commercially diagnosed Americans insured between 30 and 64 with early-onset dementia or Alzheimer’s disease increased by 200% between 2013 and 2017.