A DESCRIPTIVE EXAMINATION OF TRENDS IN HEALTHCARE RESOURCE UTILIZATION OVER A 5-YEAR PERIOD PRIOR TO DIAGNOSIS OF ALZHEIMER'S DISEASE DEMENTIA
Author(s)
Abbass IM1, DeClue R2, Choi D1, Seleri S1, Ruble M2, van Amerongen D3, Wallick C1, Suehs B2
1Genentech, Inc., South San Francisco, CA, USA, 2Humana Inc., Louisville, KY, USA, 3Humana of Ohio, Cincinnati, OH, USA
OBJECTIVES : Alzheimer’s disease (AD) is part of a continuum, starting with brain pathology in cognitively normal individuals, followed by an extended prodromal period characterized by a progressive decline in cognitive function. Most studies examine the 2 years before AD-dementia diagnosis (AD-DX) at most. We sought to examine trends in healthcare resource utilization (HRU) measures 5 years prior to first AD-DX. METHODS : Individuals enrolled in a Medicare Advantage Prescription Drug plan and newly diagnosed with AD-dementia between 01/01/2012 and 06/30/2018 were identified and matched on pre-diagnosis characteristics to clinically similar individuals who did not develop AD or related dementia. HRU measures included physician office (PO) visits; inpatient admissions (IA); emergency department (ED) visits. We descriptively examined quarterly HRU rates for the AD vs. non-AD cohorts over the 5-year period prior to AD-DX. RESULTS : In total, 27,308 individuals were matched and included in each group. Rates of PO encounters were relatively stable during the pre-diagnosis period. In the quarter immediately preceding AD-DX, PO service use was greater in the AD vs. non-AD cohort (3,067 vs. 2,174 per 1,000). There was an early divergence in IA and ED use 4 years prior to AD-DX: 47 and 139 per 1,000, respectively, for the AD cohort vs. 35 and 96 per 1,000 for the non-AD cohort, increasing to 180 and 590 per 1,000 in the quarter immediately before AD-DX in the AD cohort. In the non-AD cohort, quarterly IA and ED were relatively stable over the pre-diagnosis period (range: 30-41 and 92-125 per 1,000, respectively). CONCLUSIONS : Trends in HRU among individuals who go on to have an AD-DX showed marked differences compared with matched individuals who do not. Further research should examine specific HRU types that may serve as signals to support early identification, interventions, and patient services for individuals at high risk for AD-DX.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PND56
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Neurological Disorders