Wisconsin Healthcare Utilization Cost Among American Indians/Alaska Natives with and without Alzheimer’s Disease and Related Dementias

Article type: Short Communication

Authors: Johnson, Adrienne L.^{a; *} | Seep, Elaina^b | Norton, Derek L.^{c; d} | Mundt, Marlon P.^{a; e} | Wyman, Mary F.^{c; f} | James, Taryn T.^{c; f} | Zuelsdorff, Megan^{c; g} | Lambrou, Nickolas H.^{c; h} | McLester-Davis, Lauren W.Y.ⁱ | Umucu, Emre^j | Gleason, Carey E.^{c; f; h}

Affiliations: [a] University of Wisconsin School of Medicine & Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA | [b] Aniwahya Consulting Services, Sun Prairie, WI, USA | [c] Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA | [d] Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA | [e] Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA | [f] VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA | [g] University of Wisconsin-Madison School of Nursing, Madison, WI, USA | [h] University of Wisconsin, Division of Geriatrics, Madison, WI, USA | [i] Neuroscience Program, Tulane Brain Institute, Tulane University, New Orleans, LA, USA | [j] Michigan State University, East Lansing, MI, USA

Correspondence: [*] Correspondence to: Adrienne L. Johnson, PhD, Center for Tobacco Research and Intervention, 1900 Monroe St., Ste. 200, Madison, WI 53711, USA. Tel.: +1 608 265 4797; E-mail: aljohnson43@ctri.wisc.edu.

Abstract: Individuals with Alzheimer’s disease and related dementias (ADRD) accrue higher healthcare utilization costs than peers without ADRD, but incremental costs of ADRD among American Indians/Alaska Natives (AI/AN) is unknown. State-wide paid electronic health record data were retrospectively analyzed using percentile-based bootstrapped 95% confidence intervals of the weighted mean difference of total 5-year billed costs to compare total accrued for non-Tribal and Indian Health Service utilization costs among Medicaid and state program eligible AI/AN, ≥40 years, based on the presence/absence of ADRD (matching by demographic and medical factors). AI/AN individuals with ADRD accrued double the costs compared to those without ADRD, costing an additional $880.45 million to $1.91 billion/year.

Keywords: Alaska Native, Alzheimer’s disease, American Indian, cost, dementia, healthcare utilization, incremental cost, Medicaid, Native American

DOI: 10.3233/JAD-220393

Journal: Journal of Alzheimer's Disease, vol. 91, no. 1, pp. 183-189, 2023