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Published on: September 30, 2020
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.
Objective:
To evaluate health care utilization in veterans with Alzheimer disease (AD) in the Veterans Affairs health system (VAHS).
Study Design:
This retrospective analysis identified veterans with AD using clinical notes extracted from the VAHS electronic health record from fiscal years 2010 to 2019.
Methods:
The first note identifying AD was the index date. Health care utilization in veterans with AD and a 1:1 matched comparison group without AD was evaluated at 2 years preindex, 1 year preindex, 1 year post index, and 2 years post index.
Results:
From clinical notes, we identified 571,671 veterans with AD and 571,671 for the comparison group (overall: mean age, 74 years; 96% male; 75% White). In those with AD, outpatient visits per patient per year peaked 1 year post index at 67 and remained elevated 2 years post index at 57; without AD, the rate was approximately 19 at all time points. Hospitalization rates peaked at 1 year post index with AD but were lower and generally stable without AD. Nursing home utilization was relatively low overall. Veterans meeting the 2-code criteria (n = 56,305), defined as having 2 diagnostic codes for AD recorded at least 30 days apart, had consistently higher utilization than veterans without AD (especially post index).
Conclusion:
Veterans with AD have higher health care utilization than veterans without AD, especially around the time of AD diagnosis.
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