Differences in service utilization at an urban tribal health organization before and after Alzheimer's disease or related dementia diagnosis: A cohort study

Alzheimers Dement. 2019 Nov;15(11):1412-1419. doi: 10.1016/j.jalz.2019.06.4945. Epub 2019 Sep 25.

Abstract

Introduction: The prevalence, mortality, and healthcare impact of Alaska Native and American Indian (ANAI) people with Alzheimer's disease and related dementias (ADRD) are unknown.

Methods: We conducted a cohort study of electronic health record data that compared healthcare service utilization in patients with and without an ADRD diagnosis. Zero-inflated negative binomial regression with robust standard errors was used to estimate utilization rates.

Results: Compared with patients without ADRD, utilization rates were similar before but higher after ADRD diagnosis. For those with diagnosed ADRD, utilization increased gradually over time with sharp upward change during the year of diagnosis.

Discussion: This is the only study quantifying changes in healthcare service utilization before and after ADRD diagnosis among ANAI people, which is crucial for tailoring geriatric care for ANAI populations.

Keywords: Alaska Native; Alzheimer disease; American Indian; Delivery of healthcare; Dementia; Geriatrics; Health services.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alaska Natives / statistics & numerical data*
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / mortality
  • Cohort Studies
  • Dementia / diagnosis
  • Dementia / epidemiology
  • Dementia / mortality
  • Electronic Health Records / statistics & numerical data
  • Female
  • Humans
  • Indians, North American / statistics & numerical data*
  • Male
  • Medicare / statistics & numerical data
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prevalence
  • United States / epidemiology