Use and cost of hospitalization of patients with AD by stage and living arrangement - CERAD XXI

Objective: To determine the probability, frequency, length of stay, and Med icare costs of hospitalization of institutionalized and noninstitutionalize d patients with AD at various stages of dementia. Methods: The authors anal yzed the 1991 to 1995 Medicare records of 420 CERAD patients with AD, a gro up which, at entry, had no serious comorbidities. They were geographically distributed across the United States and observed for a median of 2.5 years . Repeated measures logistic regression and generalized estimating equation s were used to model the,probability of hospitalization. Among those hospit alized, the general linear mixed model was used to determine number of admi ssions, length of stay, and Medicare cost. Demographic characteristics and calendar date were controlled in all analyses. Results: As dementia worsene d, the probability of hospitalization increased among patients living at ho me, but decreased among those who were institutionalized. Number of admissi ons, length of stay, and cost also decreased significantly as stage worsene d among the institutionalized patients, but the stage of dementia had no ef fect in non-institutionalized patients. Conclusion: The hospitalization exp erience of patients with AD living at home differs from that of patients wi th AD living in institutions. Residential setting appears to be an importan t determinant of hospitalization in patients with AD.