Public Health.

Area of Science:

• Gerontology
• Health Services Research
• Clinical Pharmacy

Background:

• Primary Care Providers (PCPs) are crucial for dementia diagnosis and ongoing care.
• PCPs manage dementia symptom medications and behavioral drugs, but their impact on patient outcomes is not fully understood.
• Understanding PCP medication management practices is vital for improving dementia care.

Purpose of the Study:

• To investigate variations in medication management by PCPs for individuals with dementia.
• To determine the impact of PCP medication management on dementia patient hospitalizations and emergency department utilization.

Main Methods:

• Utilized a difference-in-differences model with Medicare claims data.
• Focused on beneficiaries who switched PCPs due to provider exit to isolate PCP impact.
• Analyzed healthcare utilization for beneficiaries aged 65+ enrolled in Medicare Advantage or Part D.

Main Results:

• In 2017, over 10.7 million beneficiaries had an assigned PCP; 325,995 experienced a PCP exit.
• Approximately 50.4% of affected beneficiaries had claims for dementia symptom management drugs.
• Current analysis explores how switching to PCPs with higher medication management intensity affects patient healthcare use.

Conclusions:

• Significant variation exists in PCP prescribing patterns for dementia and behavioral symptom medications.
• Further investigation is underway to identify PCP-level factors driving this variation and its effect on patient outcomes.