title: Road to the nursing home: costs and disease progression among medicare beneficiaries with ADRD.
abstract: OBJECTIVE
  To estimate long-term care costs and disease progression among Medicare beneficiaries aged 65+ with ADRD.
  
  
  METHODS
  Retrospective analysis of Medicare Part A claims and nursing home (NH) Minimum Data Set (MDS) records among beneficiaries 1999-2007. Expenditures were grouped into 3 periods; PRE, events occurring between date of ADRD diagnosis, before first NH admission; PERI, from first NH admission to at least 100 days; and, PERM, after 120 days. Utilization and reimbursements were computed for each period.
  
  
  RESULTS
  Demographics of the3,681,702 ADRD beneficiaries showed average age of 83 (+/-7), female (67.7%) and white (87.4%). Medicare reimbursements per person increased by 58% from the PRE ($47,912) to PERM period ($75,654). Age, ethnicity, gender (male), and comorbidities were significantly related to total reimbursements in each phase.
  
  
  CONCLUSIONS
  Applying a taxonomy of NH phases, Medicare expenditures per person year are higher among patients in their terminal phase and higher still with comorbidities.
authors.affiliation: Center for Gerontology & Healthcare, Health Services Policy & Practice, Brown University, Providence, RI, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Bentkover
authors.forename: Shubing
authors.initials: S
authors.lastname: Cai
authors.forename: Rajesh
authors.initials: R
authors.lastname: Makineni
authors.forename: Lisa
authors.initials: L
authors.lastname: Mucha
authors.forename: Michael
authors.initials: M
authors.lastname: Treglia
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics*; D018450:Disease Progression; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics*; D009735:Nursing Homes / Q000191:economics*; D012189:Retrospective Studies; D014481:United States