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Health care utilization in veterans with Alzheimer disease
Ying Wang1,2, Byron J Aguilar1, Mingfei Li3,4
1Geriatric Research Education and Clinical Center, VA Bedford Healthcare System, Bedford, MA.
The American Journal of Managed Care
|June 23, 2026
Summary
Veterans with Alzheimer disease (AD) experience significantly higher healthcare use, particularly outpatient visits and hospitalizations, following diagnosis. This increased utilization highlights the substantial impact of AD on healthcare resource demands within the VA system.
Area of Science:
- Gerontology
- Neurology
- Health Services Research
Background:
- Alzheimer disease (AD) is a progressive neurodegenerative disorder.
- The Veterans Affairs health system (VAHS) serves a large population of veterans, many of whom may develop AD.
- Understanding healthcare utilization patterns in veterans with AD is crucial for resource allocation and care planning.
Purpose of the Study:
- To evaluate and quantify healthcare utilization among veterans diagnosed with Alzheimer disease (AD).
- To compare healthcare utilization in veterans with AD to a matched cohort without AD within the VAHS.
- To analyze utilization trends at various time points relative to the AD diagnosis index date.
Main Methods:
- Retrospective analysis of electronic health records from the VAHS (fiscal years 2010-2019).
- Identification of veterans with AD based on clinical notes, with the first AD note serving as the index date.
- 1:1 matching of veterans with AD to a comparison group without AD, evaluating utilization at 2 years pre-index, 1 year pre-index, 1 year post-index, and 2 years post-index.
Main Results:
- A total of 571,671 veterans with AD and an equal number of controls were analyzed.
- Veterans with AD showed markedly higher outpatient visits (peaking at 67 visits/year post-index) compared to controls (approx. 19 visits/year).
- Hospitalization rates were also higher in the AD cohort, particularly 1 year post-diagnosis. Veterans meeting stricter diagnostic criteria (2 codes, ≥30 days apart) exhibited consistently higher utilization.
Conclusions:
- Veterans diagnosed with Alzheimer disease exhibit significantly elevated healthcare utilization compared to their non-AD counterparts.
- The period surrounding the AD diagnosis is associated with a substantial increase in healthcare resource use.
- These findings underscore the significant burden of Alzheimer disease on healthcare systems serving veteran populations.
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