Association of dementia with early rehospitalization among Medicare beneficiaries
Abstract
Preventable hospital readmissions have been recognized as indicators of hospital quality, a source of increased healthcare expenditures, and a burden for patients, families, and caregivers. Despite growth of initiatives targeting risk factors associated with potentially avoidable hospital readmissions, the impact of dementia on the likelihood of rehospitalization is poorly characterized. Therefore, the primary objective of this retrospective cohort study was to investigate whether dementia was an independent predictor of 30-day readmissions. Administrative claims data for all admissions to Rhode Island hospitals in 2009 was utilized to identify hospitalizations of Medicare fee-for-service beneficiaries with a diagnosis of Alzheimer's Disease or other dementias. Demographics, measures of comorbid disease burden, and other potential confounders were extracted from the data and the odds of 30-day readmission to any United States hospital was calculated from conditional logistic regression models. From a sample of 25,839 hospitalizations, there were 3908 index admissions of Medicare beneficiaries who fulfilled the study criteria for a dementia diagnosis. Nearly 20% of admissions (n=5133) were followed by a readmission within thirty days. Hospitalizations of beneficiaries with a dementia diagnosis were more likely to be followed by a readmission within thirty days (adjusted odds ratio (AOR) 1.18; 95% CI, 1.08, 1.29), compared to hospitalizations of those of without dementia. Controlling for discharge site of care did not attenuate the association (AOR 1.21; 95% CI, 1.10, 1.33).
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Support was rarely inclusive of dementia-specific needs, which was linked to increased readmissions.
“This was rarely inclusive of dementia-specific needs, such as reducing the number of different visitors at home or fitting around the patient’s routine to reduce distress, which was linked to increased readmissions [43, 54, 95, 96].”
From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [96]
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- Authors
- Daiello, L. A., Gardner, R., Epstein-Lubow, G., Butterfield, K., & Gravenstein, S.
- Affiliations
- Brown University (US)
- Healthcentric Advisors (US)
- Corresponding author
- Daiello, Lori A.
- Venue
- Archives of Gerontology and Geriatrics
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 59
- Issue
- 1
- Pages
- 162-168
- ISSN
- 0167-4943 (ISSN-L)
- OpenAlex
- W2062918847
- Cited by
- 81
- References
- 39
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 11 · 2021: 10 · 2020: 12 · 2019: 6 · 2018: 9 · 2017: 4 · 2016: 8 · 2015: 6
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Gerontology and Geriatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- John A. Hartford Foundation
- Agency for Healthcare Research and Quality (K08HS017735)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia, hospital readmission, 30-day readmission, Medicare beneficiaries, Alzheimer's disease, hospital quality, older adults
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Medicare, Humans, Male, Middle Aged, Patient Readmission, Retrospective Studies, Rhode Island, Risk Factors, United States, Comorbidity, Fee-for-Service Plans
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