Trends, Predictors, and Outcomes of Healthcare Resources Used in Patients Hospitalized with Alzheimer’s Disease with at Least One Procedure: The Nationwide Inpatient Sample

Article type: Research Article

Authors: Beydoun, May A.^{a; *} | Gamaldo, Alyssa A.^{a; b} | Beydoun, Hind A.^c | Shaked, Danielle^{a; d} | Zonderman, Alan B.^{a; 1} | Eid, Shaker M.^{c; 1}

Affiliations: [a] National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA | [b] Human development and Family Studies, Penn State University, State College, PA, USA | [c] Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA | [d] Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, USA

Correspondence: [*] Correspondence to: May A. Beydoun, PhD, NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room #:04B118, Baltimore, MD 21224, USA. Fax: +1 410 558 8236; E-mail: baydounm@mail.nih.gov.

Note: [1] Co-senior authors.

Abstract: We assessed trends, predictors and outcomes of resource utilization in hospital inpatient discharges with a principal diagnosis of Alzheimer’s disease (AD) with at least one procedure. Using Nationwide Inpatient Sample data (NIS, 2002–2012), discharges primarily diagnosed with AD, aged ≥60 y and with ≥1 procedure, were selected (Weighted N = 92,300). Hospital resource utilization were assessed using ICD-9-CM codes, while hospitalization outcomes included total charges (TC, 2012$), length of stay (LOS, days), and mortality risk (MR, %). Brain and respiratory/gastrointestinal procedure utilization both dropped annually by 3–7%, while cardiovascular procedures/evaluations, blood evaluations, blood transfusion, and resuscitation (“CVD/Blood”) as well as neurophysiological and psychological evaluation and treatment (“Neuro”) procedures increased by 5–8%. Total charges, length of stay, and mortality risk were all markedly higher with use of respiratory/gastrointestinal procedures as opposed to being reduced with use of “Brain” procedures. Procedure count was positively associated with all three hospitalization outcomes. In sum, patterns of hospital resources that were used among AD inpatients changed over-time, and were associated with hospitalization outcomes such as total charges, length of stay, and mortality risk.

Keywords: Alzheimer’s disease, healthcare resource utilization, hospital inpatients, hospitalization outcomes, hospital procedures

DOI: 10.3233/JAD-161225

Journal: Journal of Alzheimer's Disease, vol. 57, no. 3, pp. 813-824, 2017