Clinical and Demographic Profiles of Home Care Patients With Alzheimer's Disease and Related Dementias: Implications for Information Transfer Across Care Settings.
Miriam RyvickerYolanda BarrónShivani ShahStanley M MooreJames M NobleKathryn H BowlesJacqueline MerrillPublished in: Journal of applied gerontology : the official journal of the Southern Gerontological Society (2021)
Home health care (HHC) clinicians serving individuals with Alzheimer's disease and related dementias (ADRD) do not always have information about the person's ADRD diagnosis, which may be used to improve the HHC plan of care. This retrospective cohort study examined characteristics of 56,652 HHC patients with varied documentation of ADRD diagnoses. Data included clinical assessments and Medicare claims for a 6-month look-back period and 4-year follow-up. Nearly half the sample had an ADRD diagnosis observed in the claims either prior to or following the HHC admission. Among those with a prior diagnosis, 63% did not have it documented on the HHC assessment; the diagnosis may not have been known to the HHC team or incorporated into the care plan. Patients with ADRD had heightened risk for adverse outcomes (e.g., urinary tract infection and aspiration pneumonia). Interoperable data across health care settings should include ADRD-specific elements about diagnoses, symptoms, and risk factors.
Keyphrases
- healthcare
- palliative care
- affordable care act
- risk factors
- quality improvement
- health insurance
- electronic health record
- urinary tract infection
- emergency department
- health information
- cognitive decline
- big data
- intensive care unit
- machine learning
- physical activity
- social media
- mild cognitive impairment
- chronic pain
- artificial intelligence
- extracorporeal membrane oxygenation