One-year Medicare costs associated with delirium in older hospitalized patients with and without Alzheimer's disease dementia and related disorders

Introduction: One-year health-care costs associated with delirium in older hospitalized patients with and without Alzheimer's disease and related dementias (ADRD) have not been examined previously.

Methods: Medicare costs were determined prospectively at discharge, and at 30, 90, and 365 days in a cohort (n = 311) of older adults after hospital admission.

Results: Seventy-six (24%) patients had ADRD and were more likely to develop delirium (51% vs. 24%, P < 0.001) and die within 1 year (38% vs. 21%, P = 0.002). In ADRD patients with versus without delirium, adjusted mean difference in costs associated with delirium were $34,828; most of the excess costs were incurred between 90 and 365 days (P = 0.03). In non-ADRD patients, delirium was associated with increased costs at all timepoints. Excess costs associated with delirium in ADRD patients increased progressively over 1 year, whereas in non-ADRD patients the increase was consistent across time periods.

Discussion: Our findings highlight the complexity of health-care costs for ADRD patients who develop delirium, a potentially preventable source of expenditures.

Highlights: Novel examination of health-care costs of delirium in persons with and without Alzheimer's disease and related dementias (ADRD). Increased 1-year costs of $34,828 in ADRD patients with delirium (vs. without). Increased costs for delirium in ADRD occur later during the 365-day study period. For ADRD patients, cost differences between those with and without delirium increased over 1 year. For non-ADRD patients, the parallel cost differences were consistent over time.

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Work Title One-year Medicare costs associated with delirium in older hospitalized patients with and without Alzheimer's disease dementia and related disorders
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Open Access
Creators
  1. Tammy T. Hshieh
  2. Ray Yun Gou
  3. Richard N. Jones
  4. Douglas L. Leslie
  5. Edward R. Marcantonio
  6. Guoquan Xu
  7. Thomas G. Travison
  8. Tamara G. Fong
  9. Eva M. Schmitt
  10. Sharon K. Inouye
Keyword
  1. Alzheimer’s dementia
  2. Costs of illness
  3. Delirium
  4. Delirium severity
  5. Dementia
  6. Health-care costs
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Alzheimer's and Dementia
Publication Date November 10, 2022
Publisher Identifier (DOI)
  1. https://doi.org/10.1002/alz.12826
Deposited November 27, 2023

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  • Created
  • Added Alzheimer_s___Dementia_-_2022_-_Hshieh_-_One_year_Medicare_costs_associated_with_delirium_in_older_hospitalized_patients.pdf
  • Added Creator Tammy T. Hshieh
  • Added Creator Ray Yun Gou
  • Added Creator Richard N. Jones
  • Added Creator Douglas L. Leslie
  • Added Creator Edward R. Marcantonio
  • Added Creator Guoquan Xu
  • Added Creator Thomas G. Travison
  • Added Creator Tamara G. Fong
  • Added Creator Eva M. Schmitt
  • Added Creator Sharon K. Inouye
  • Published
  • Updated Keyword, Description, Publication Date Show Changes
    Keyword
    • Alzheimer’s dementia, Costs of illness, Delirium, Delirium severity, Dementia, Health-care costs
    Description
    • <p>Introduction: One-year health-care costs associated with delirium in older hospitalized patients with and without Alzheimer's disease and related dementias (ADRD) have not been examined previously. Methods: Medicare costs were determined prospectively at discharge, and at 30, 90, and 365 days in a cohort (n = 311) of older adults after hospital admission. Results: Seventy-six (24%) patients had ADRD and were more likely to develop delirium (51% vs. 24%, P &lt; 0.001) and die within 1 year (38% vs. 21%, P = 0.002). In ADRD patients with versus without delirium, adjusted mean difference in costs associated with delirium were $34,828; most of the excess costs were incurred between 90 and 365 days (P = 0.03). In non-ADRD patients, delirium was associated with increased costs at all timepoints. Excess costs associated with delirium in ADRD patients increased progressively over 1 year, whereas in non-ADRD patients the increase was consistent across time periods. Discussion: Our findings highlight the complexity of health-care costs for ADRD patients who develop delirium, a potentially preventable source of expenditures. Highlights: Novel examination of health-care costs of delirium in persons with and without Alzheimer's disease and related dementias (ADRD). Increased 1-year costs of $34,828 in ADRD patients with delirium (vs. without). Increased costs for delirium in ADRD occur later during the 365-day study period. For ADRD patients, cost differences between those with and without delirium increased over 1 year. For non-ADRD patients, the parallel cost differences were consistent over time.</p>
    • Introduction: One-year health-care costs associated with delirium in older hospitalized patients with and without Alzheimer's disease and related dementias (ADRD) have not been examined previously.
    • Methods: Medicare costs were determined prospectively at discharge, and at 30, 90, and 365 days in a cohort (n = 311) of older adults after hospital admission.
    • Results: Seventy-six (24%) patients had ADRD and were more likely to develop delirium (51% vs. 24%, P &lt; 0.001) and die within 1 year (38% vs. 21%, P = 0.002). In ADRD patients with versus without delirium, adjusted mean difference in costs associated with delirium were $34,828; most of the excess costs were incurred between 90 and 365 days (P = 0.03). In non-ADRD patients, delirium was associated with increased costs at all timepoints. Excess costs associated with delirium in ADRD patients increased progressively over 1 year, whereas in non-ADRD patients the increase was consistent across time periods.
    • Discussion: Our findings highlight the complexity of health-care costs for ADRD patients who develop delirium, a potentially preventable source of expenditures.
    • Highlights: Novel examination of health-care costs of delirium in persons with and without Alzheimer's disease and related dementias (ADRD). Increased 1-year costs of $34,828 in ADRD patients with delirium (vs. without). Increased costs for delirium in ADRD occur later during the 365-day study period. For ADRD patients, cost differences between those with and without delirium increased over 1 year. For non-ADRD patients, the parallel cost differences were consistent over time.
    Publication Date
    • 2023-05-01
    • 2022-11-10
  • Updated