Use of Inpatient Psychiatric Facilities by Medicare Beneficiaries with Dementia.

Abstract

Alzheimer's dementia, the most common type of dementia, afflicts more than 6 million Americans. More than 80 percent of people living with dementia (PLWD) live in the community, either with caregivers or alone. As cognitive impairment becomes more severe, behavioral and psychological symptoms of dementia (BPSD) become more difficult to manage, and those with severe or dangerous BPSD may need to be treated in an inpatient psychiatric facility (IPF). The immediate goal of an IPF stay is to stabilize patients in a psychiatric crisis. IPFs primarily serve people with serious mental illness and substance use disorders, whose care needs may overlap with but also differ from the needs of PLWD. Little is known about PLWD who use IPFs. The goal of this research was to conduct exploratory analyses focused on PLWD who use IPFs to (1) characterize the population and compare them with IPF users without dementia, (2) examine characteristics and utilization patterns for different services and settings that may be associated with IPF stays, and (3) analyze outcomes following IPF stays. The authors used Medicare fee-for-service data to conduct descriptive analyses characterizing beneficiaries with dementia who experienced an IPF stay in 2018 and compare them with beneficiaries without dementia. The research team used regression analyses to explore predictors of IPF use and service use and outcomes after IPF discharge.