HOSPITALIZATION COSTS ASSOCIATED WITH 30-DAY UNPLANNED READMISSIONS AND POTENTIALLY PREVENTABLE READMISSIONS IN US OLDER PATIENTS WITH ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Author(s)
Jun Wu, PhD1, Kevin Lu, PhD2, Mary Lynn Davis-Ajami, MBA, PhD3.
1Professor, Nova Southeastern University College of Pharmacy, Fort Lauderdale, FL, USA, 2University of South Carolina, Columbia, SC, USA, 3Cleveland State University, Cleveland, OH, USA.
1Professor, Nova Southeastern University College of Pharmacy, Fort Lauderdale, FL, USA, 2University of South Carolina, Columbia, SC, USA, 3Cleveland State University, Cleveland, OH, USA.
OBJECTIVES: Older patients with Alzheimer’s disease and related dementias (ADRD) face high rates of unplanned hospital readmissions, many of which may be avoidable through better care coordination and post-discharge support. This study aimed to examine the costs associated with 30-day unplanned readmissions and potentially preventable readmissions (PPRs) among US older patients with ADRD.
METHODS: This study utilized the 2022 Nationwide Readmission Database to identify index admissions, 30-day unplanned readmissions, and PPRs in patients ≥ 65 years with ADRD, applying the Centers for Medicare and Medicaid Hospital-Wide Readmission measures. Cost outcomes were assessed at the patient and event levels, including annual total hospitalization, 30-day unplanned readmission, and PPR costs.
RESULTS: Of the older patients with ADRD, 20.6% experienced at least one 30-day unplanned readmission. These patients incurred significantly higher average total hospitalization costs per patient, compared to those without a readmission ($67,566 vs. $27,239; p < 0.001), representing a 117% higher adjusted hospitalization cost. Among readmitted patients, 50.6% experienced at least one PPR. Patients with a PPR incurred higher average readmission costs than those without ($32,802 vs. $24,525, p < 0.001), translating to 25.9% higher adjusted readmission costs. Among all eligible discharges, unplanned readmission costs represented 14.3% of total hospitalization costs, and PPR costs accounted for 75.7% of unplanned readmission costs. The greatest contributions to PPR-related costs were infections ($780 million), followed by chronic conditions ($251 million).
CONCLUSIONS: Unplanned readmissions and PPRs were associated with significantly higher hospitalization costs for older patients with ADRD, imposing a substantial financial burden on healthcare systems and payers. Targeted efforts to improve care transitions and better manage infections and chronic conditions are critical for reducing PPRs and associated costs in this vulnerable population.
METHODS: This study utilized the 2022 Nationwide Readmission Database to identify index admissions, 30-day unplanned readmissions, and PPRs in patients ≥ 65 years with ADRD, applying the Centers for Medicare and Medicaid Hospital-Wide Readmission measures. Cost outcomes were assessed at the patient and event levels, including annual total hospitalization, 30-day unplanned readmission, and PPR costs.
RESULTS: Of the older patients with ADRD, 20.6% experienced at least one 30-day unplanned readmission. These patients incurred significantly higher average total hospitalization costs per patient, compared to those without a readmission ($67,566 vs. $27,239; p < 0.001), representing a 117% higher adjusted hospitalization cost. Among readmitted patients, 50.6% experienced at least one PPR. Patients with a PPR incurred higher average readmission costs than those without ($32,802 vs. $24,525, p < 0.001), translating to 25.9% higher adjusted readmission costs. Among all eligible discharges, unplanned readmission costs represented 14.3% of total hospitalization costs, and PPR costs accounted for 75.7% of unplanned readmission costs. The greatest contributions to PPR-related costs were infections ($780 million), followed by chronic conditions ($251 million).
CONCLUSIONS: Unplanned readmissions and PPRs were associated with significantly higher hospitalization costs for older patients with ADRD, imposing a substantial financial burden on healthcare systems and payers. Targeted efforts to improve care transitions and better manage infections and chronic conditions are critical for reducing PPRs and associated costs in this vulnerable population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD73
Topic
Health Service Delivery & Process of Care
Disease
SDC: Geriatrics, SDC: Neurological Disorders