Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

摘要

Objectives: Determine predictors of hospitalization and institutionalization in Medicaid populations with Alzheimer’s Disease (AD). Methods: Data were obtained from the Centers for Medicareand Medicaid Services (CMS). Individuals enrolled in Florida,New Jersey, and New York Medicaid programs on January 1, 2004, remained in that program for 1 year and exposed to an AD medication were included. AD diagnosis was based on the ICD-9-CM code 331.0. Outcomes of interest were hospitalization and institutionalization. Multivariate logistic regression models were used to test for the association between outcomes of interest and demographics, resource utilization factors, and type of AD pharmacotherapy exposure. Results: A total of 65,442 individuals qualified for the study. Age was positively and significantly associated with hospitalization (p likely to be hospitalized than Florida residents (OR = 1.30;99% CI: 1.17 - 1.44), where as New Jersey residents were significantly less likely to be hospitalized (OR = 0.75;99% CI: 0.66 - 0.85). Finally, compared toFloridaresidents, residents of New Jerseywere significantly more likely to be institutionalized (OR = 4.61;99% CI: 3.98 - 5.33). Conclusion: Demographics, state of residence and pharmacotherapy exposure weresignificant predictors of health care service utilization. Further pharmacoeconomic studies in AD medication therapy are warranted.