June 10 : A study estimated the association of hospital admission on health outcomes and health care spending among persons with dementia. The study found that hospital admission after an emergency department visit was not clearly associated with lower mortality, but it was associated with higher health care spending. The findings indicate that health care spending could be reduced without compromising health outcomes for some patients with dementia who present to the emergency department. The study is published in Annals of Internal Medicine.

Researchers from Kyoto University and the University of California, Los Angeles examined more than 870,000 emergency department visits by Medicare fee-for-service beneficiaries aged 66 years or older with dementia between 2017 to 2019. Of these visits, 55.3% resulted in hospital admission. They compared death rates, additional hospital days, and spending over 30 and 90 days between the two groups using an instrumental variable approach to address differences in patient severity. The study found no clear difference in survival or subsequent hospital use. However, patients who were admitted to the hospital had significantly higher health care costs. The findings suggest that some hospital admissions may provide little value for short-term health outcomes among persons with dementia.