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Saturday, December 03, 2022

More than half of adults now diagnosed with dementia die compared to two decades ago – Nation World News

Summary: About 50% of older adults now die with a recorded diagnosis of dementia, a 36% increase compared to two decades ago.

Source: University of Michigan

A new study shows that nearly half of all older adults now die with a diagnosis of dementia listed in their medical records, a 36% increase from two decades ago.

But that sharp increase may have more to do with better public awareness, more detailed medical records and Medicare billing practices than the actual increase in the situation, the researchers say.

Still, they note, it provides an opportunity for more older adults to talk in advance with their families and health care providers about what kind of care they’ll want at the end of life if they develop Alzheimer’s disease or cognitive decline. develop another form of

study, published in Jama Health Forum Data from 3.5 million people over the age of 67 who died between 2004 and 2017 are used, by a team from the University of Michigan. It focuses on the bills their providers have presented to the traditional medical system over the past two years of patients’ lives.

In 2004, about 35% of these end-of-life billing claims had at least one mention of dementia, but by 2017 this had risen to more than 47%. Even when researchers narrowed it down to patients who had at least two medical claims mentioning dementia, 39% of patients qualified, up from 25% in 2004.

The biggest jump in the percentage of people who died from a dementia diagnosis occurred when Medicare allowed hospitals, hospices and doctors’ offices to list more diagnoses on their requests for payment.

It Shows The Hand Of An Old Lady
The biggest jump in the percentage of people who died from a dementia diagnosis occurred when Medicare allowed hospitals, hospices and doctors’ offices to list more diagnoses on their requests for payment. Image is in public domain

But around the same time, the national plan to address Alzheimer’s disease also took effect, focusing on increased public awareness, quality of care, and greater support for patients and their caregivers.

The life-long care that patients with dementia receive has changed somewhat, including a drop in the percentage of those who die in a regular hospital bed or ICU bed or have had a feeding tube in the past six months. The percentage who received hospice services increased dramatically from 36% to about 63%, although the authors note that this is in line with a national trend toward more hospice care by the end of 2010.

Study senior author and professor, Julie Bynum, MD, PhD, said, “This suggests that we have a long way to go in addressing end-of-life care priorities with recently diagnosed people and their families. ” Geriatric Medicine at Michigan Medicine.

“Where once there may have been a diagnosis of anxiety, we can now focus on how we use dementia diagnosis rates in everything from national budget planning to how to adjust reimbursement for Medicare Advantage plans.”

About this dementia research news

Author: Press Office
Source: University of Michigan
Contact: Press Office – University of Michigan
Image: Image is in public domain

Basic Research: open access.
“Trends in US Medicare Declining Diagnosis of Dementia from 2004 to 2017” by Matthew A. Davis et al. Jama Health Forum


Summary

Trends in diagnoses of US Medicare declines dementia from 2004 to 2017

importance

Alzheimer’s disease and related dementia (ADRD) has attracted considerable attention among clinicians, researchers, and policy makers in recent years. Despite increased awareness, few studies have documented temporary changes in the documentation of ADRD diagnosis despite the new importance of risk adjustments to health plans in Medicare.

Objective

To assess trends in frequency of ADRD diagnosis in the last 2 years of life from 2004 to 2017 as well as any associated changes in billing practices, characteristics of the population with diagnosed ADRD, and intensity of end-of-life care.

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It Shows A Psychedelic Brain

Design, setting and participants

This is a serial cross-sectional study of older adult deceased (67 years or older) from 2004 to 2017 using a sample 20% of charge for service. An ADRD diagnosis within the last 2 years of life was identified using a diagnosis code from inpatient, professional service, home health, or hospice claims, which requires a standard claims algorithm that requires at least 1 claim. and a more rigorous algorithm that requires at least 2 assertions. , Trends in ADRD diagnosis among the dead were used to narrow down the impact of new diagnostic techniques for early-stage disease. Demographic characteristics, selected comorbidities, place of death, and end-of-life healthcare use were also examined. Data were analyzed from July 9, 2020 to May 3, 2021.

investment risk

calendar year 2004 to 2017

Main results and measures

ADRD diagnosis within 2 years of death.

Result

3 515 329 Among Medicare fee-for-service descendants, when adjusted for age and gender, the percentage of the older dead with an ADRD diagnosis increased from 34.7% in 2004 to 47.2% in 2017. The trend weakened (from 25.2% to 39.2%) using a tighter ADRD definition. There was an inflection in the curve from 2011 to 2013, at which time additional diagnoses were added to Medicare claims and the National Alzheimer’s Care Act was enacted. ADRD diagnosis frequency increased significantly in inpatient (49.0% to 67.3%), hospice (12.2% to 42.0%), and home health (10.1% to 28.7%) claims. However, individual characteristics, number of visits and hospitalizations were similar during the study period, and end-of-life care intensity declined on most measures.

Conclusion and Relevance

In this cross-sectional study, nearly half of the older Medicare decedent were diagnosed with ADRD at the time of death. From 2004 to 2017, the percentage of older adult deceased who received an ADRD diagnosis increased significantly before the announcement of adding ADRD to Medicare risk adjustment strategies.

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