Predictors of Inpatient Mortality and Resource Utilization for Hospitalized Patients with Alzheimer's Disease and Related Dementias, Controlling for Severity in the United States from 2010-2015
Author(s)
ABSTRACT WITHDRAWN
OBJECTIVES: ,
This research aims to document the severity profile of people with ADRD and compare predictors of the clinical and resource utilization outcomes across ADRD severity-categories (e.g., Mild, Moderate, Severe, and Extreme).METHODS
: Cross-sectional analysis was conducted on patients (30 years and older) who received home health care and were Medicare beneficiaries, diagnosed with ADRD (ICD-9 and ICD-10 ) in US hospitals. A total of 164,598 patients were included. Data were obtained between 2010 and 2015 from Nationwide Readmissions Database (NRD), and regression models were used to predict the study outcomes. Four severity-categories were derived from mortality risk, severity of illness, mortality scores, and readmission scores. Resulting in Mild ADRD, Moderate ADRD, Severe ADRD, and Extreme ADRD. Outcomes include 30-day hospital readmissions, in-hospital mortality, length of stay (LOS), and hospitalization costs (costs).RESULTS
: Of 164,598 ADRD patients, 3848 were Mild ADRD, 68,803 Moderate ADRD, 72,428 Severe ADRD, and 19,519 Extreme ADRD. The overall rate of 30-day readmission was 3.2%. Comparative rate between severity-category varied (p-value >0.0001): Mild ADRD (3.1%), Moderate ADRD (3.0%), Severe ADRD (3.3%), and Extreme ADRD (3.7%). 14.5% was the overall rate of in-hospital mortality. This rate between severity-category varied comparatively (p-value >0.0001): Mild ADRD (4.4%), Moderate ADRD (4.1%), Severe ADRD (14.1%), and Extreme ADRD (54.2%). The length of stay ranged from 5.5 to 6.9 days between severity-categories, whereas average patient hospitalization costs ranged between $7,763 and $14,122. After adjusting for sociodemographic and clinical characteristics, the predictors of the outcome differed across severity-categories.CONCLUSIONS
: Severe and extreme stages of ADRD are associated with increased risk for 30-day readmissions, in-hospital death, LOS, and costs. Findings support that adults admitted to home health care with the severe or extreme stage of ADRD might require more lavish attention and specialized care to minimize adverse outcomes, as early readmissions, death, and higher LOS and costs.Conference/Value in Health Info
2022-05, ISPOR 2022, Washington, DC, USA
Value in Health, Volume 25, Issue 6, S1 (June 2022)
Acceptance Code
P17
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment, Performance-based Outcomes
Disease
Neurological Disorders