Objective: Comorbid conditions and healthcare costs were analyzed for patients with Alzheimer’s disease (AD) in a Medicare-Managed Care Organization (MCO), and implications for disease management programs were derived.
Design: A retrospective case-control analysis was conducted of administrative data for AD patients (3517) and age-gender–matched controls (17,480) selected from a Medicare-MCO.
Materials and Methods: AD patients were identified from ICD-9CM diagnosis codes on the MCO’s claims records. The prevalence of AD and 16 comorbid conditions identified using diagnostic classifications from the Charlson Comorbidity Index were determined. Cost estimates were derived from regression models, controlling for age, gender, and comorbid conditions. The sensitivity of study results to alternative specifications of ICD-9CM codes for selection of cases was examined.
Results: The prevalence of AD in the MCO was 3.9%. Annual healthcare costs were $3706 higher for AD patients than controls. Costs for comorbid conditions were higher for AD patients: compared with controls with the same conditions, costs were $5389 higher for patients with AD and congestive heart failure (CHF), $7410 higher for AD and diabetes with chronic complications, and $4404 higher for AD and diabetes without complications. Increased healthcare costs for AD patients were attributable to greater utilization of inpatient and skilled nursing facilities. Similar results were obtained from more restrictive and less restrictive selection criteria on ICD-9CM codes.
Conclusion: Costs for AD patients in a Medicare-MCO were 1.6 times higher than for controls and significantly higher for 13 of 16 comorbid conditions examined, including CHF and diabetes. Much of these costs appeared to be related to potentially avoidable hospitalizations. These findings demonstrate the need for early identification of patients with AD in order to improve the quality of care and potentially reduce healthcare costs in frail elderly with multiple comorbidities. Benefits may be achieved through modification of existing disease management and geriatric case management programs to include guidelines specific to patients with AD.
Back to S073 Health Economics and Public Health Implications of Alzheimer's Disease with and without Medical Co-Morbidities
Back to The Eleventh International Congress