Incremental Health Care Expenditures of the Spouses of Older Adults With Alzheimer's Diseases and Related Dementias (ADRD)
Open accessAbstract
Objective Previous research has found that having a spouse with Alzheimer's disease and related dementias (ADRD) is associated with higher health care expenditures, however it is unclear if this difference remains after accounting for the demographics and health status of the non-ADRD spouse. This paper aims to estimate the adjusted incremental health care expenditures of having a spouse with ADRD.Design Cross-sectional study of publicly available survey data (2003-2017 Medical Expenditure Panel Survey).Setting Representative sample of U.S. households.Participants Community-dwelling and married older adults (n = 28,356).Measurement Two-part models and recycled prediction techniques to estimate the incremental effects of having a spouse with ADRD on annual health care expenditures, while adjusting for demographics, socioeconomic characteristics, and health conditions.Results Spouses of older adults with ADRD were older, had worse perceived mental health, and had greater difficulties with activities of daily living, compared to older adults with cognitively normal spouses. Spouses of ADRD patients had significantly higher unadjusted total health care expenditures, however their adjusted incremental expenditure was not significantly greater. After controlling for demographics and health status, ADRD spouses had significantly higher home health care expenditures, but significantly lower outpatient expenditures.Conclusion Results suggested that the higher health care expenditures in older adults with ADRD spouses can be attributed to the higher rate of comorbidities, rate of functional limitations, and mean age in this group. The increased use of home health and decreased use of outpatient in this population suggests the importance of tailoring preventative health care and social services to meet the needs of this group.
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The expenditure pattern suggests a possible substitution effect and greater referrals to home health care by providers for patients with dementia.
“which suggests a possible”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [536]
The Discussion says home health may substitute for outpatient services and suggests that providers referring patients with dementia for home care may also refer their spouses. It does not establish greater referral rates for patients with dementia; the expenditure pattern studied concerns their spouses. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSpousal caregivers of people with dementia have higher home health care expenditures but lower outpatient expenditures than those without a spouse with dementia.
“Caregivers of a spouse with dementia indicate higher home health care expenditures but lower outpatient expenditures than those who do not have a spouse with dementia, which suggests a possible”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [536]
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- Authors
- Chu, J., Benjenk, I., & Chen, J.
- Affiliations
- University of Maryland, College Park (US)
- Corresponding author
- Chu, Jun
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 29
- Issue
- 5
- Pages
- 462-472
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC7525656
- OpenAlex
- W3090382492
- Cited by
- 17
- References
- 48
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 2 · 2020: 2
- FWCI
- 1.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01MD011523-03S1, R56AG062315)
- National Institute on Minority Health and Health Disparities (R01MD011523)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › General Health Professions › Global Health Care Issues
- Keywords
- Alzheimer's disease and related dementias, health care expenditure, home health care, outpatient care, functional limitations, comorbidities, caregiver burden, older adults, family caregiving
- MeSH terms
- Activities of Daily Living, Aged, Alzheimer Disease, Cross-Sectional Studies, Health Expenditures, Humans, United States, Spouses
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