Hospital admissions, outpatient visits and healthcare costs of community‐dwellers with Alzheimer's disease
Abstract
Background: Detailed data on the health care service use of people with Alzheimer's disease (AD) are scarce. Methods: We assessed the health care service use of all community‐dwelling persons with clinically verified AD diagnosis, residing in Finland on December 31, 2005 (n = 27,948) in comparison to matched cohort without AD. Hospitalization data during 2006–2009 were extracted from the National Hospital Discharge Register. Results: Comorbidity‐adjusted incidence rate ratios; IRR (95% CI) were 1.25 (1.22–1.28) for inpatient admissions and 0.72 (0.68–0.77) for outpatient visits. People with AD had more general health care admissions (IRR, 95%CI 1.73, 1.67–1.80) but less admissions to specialty units 0.82 (0.79–0.85) than the non‐AD group, with psychiatry being the only specialty with more admissions in the AD group. People with AD had 16 more hospital days/person‐year. Conclusions: It would be important to assess whether inpatient hospitalizations of AD patients could be decreased by better targeting of outpatient services and whether other conditions are underdiagnosed or undertreated among persons with AD.
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Dementia progression influenced the perceived appropriateness of treatments, as changing understanding of risk and benefit to the patient's quality of life was linked to decisions not to treat certain conditions (CMOC3).
“However, dementia progression influenced the perceived appropriateness of treatments, as changing understanding of risk and benefit to the patient’s quality of life was linked to decisions not to treat certain conditions (CMOC3) [45, 60, 74].”
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 [74]
When dementia was diagnosed, limited knowledge often prevented HCPs from effectively planning care or addressing the impact of dementia symptoms on condition management (CMOC9).
“When dementia was diagnosed, limited knowledge often prevented HCPs from effectively planning care or addressing the impact of dementia symptoms on condition management (CMOC9) [46, 51, 54, 73, 74, 77, 83–85].”
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 [74]
Collaboration between healthcare professionals was associated with delayed discharges, emphasising the problem in care co-ordination.
“As a result, collaboration between HCPs was associated with delayed discharges, emphasising the problem in care co-ordination (CMOC19) [40, 42, 74, 83, 88, 91, 92].”
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 [74]
There is a clear lack of appropriate knowledge and training for healthcare professionals on dementia, which had a knock-on effect on discharge planning and patient access to services.
“Our findings suggest that there is a clear lack of appropriate knowledge and training for HCPs on dementia, which had a knock-on effect on discharge planning and patient access to services [46, 50, 51, 54, 59, 61, 73, 74, 77, 78, 80–86].”
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 [74]
Studies have shown twofold differences between hospital use in dementia compared with non-dementia cohorts, including those that addressed differences in population characteristics using propensity score matching.
“Studies have shown twofold differences between hospital use in dementia compared with non-dementia cohorts,5 11 31 32 including those who have addressed the differences in population characteristics using propensity score matching.3”
From Trajectories of health system use and survival for community-dwelling persons with dementia: a cohort study (2020) · cites this paper as [5]
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- Authors
- Tolppanen, A., Taipale, H., Purmonen, T., Koponen, M., Soininen, H., & Hartikainen, S.
- Affiliations
- University of Eastern Finland (FI)
- Medfiles (Finland) (FI)
- Corresponding author
- Tolppanen, Anna‐Maija
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2014-12-10
- Volume
- 11
- Issue
- 8
- Pages
- 955-963
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- OpenAlex
- W2045259386
- Cited by
- 36
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 8 · 2017: 6 · 2016: 3 · 2015: 1
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Itä-Suomen Yliopisto
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- Alzheimer's disease, health care utilization
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alzheimer Disease, Female, Finland, Hospitalization, Humans, Male, Middle Aged, Outpatients, Psychiatric Status Rating Scales, Residence Characteristics, Cohort Studies, Health Care Costs, Outcome Assessment, Health Care
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