Emergency Department Visits and Hospital Admissions Among Older Adults With and Without Dementia Receiving Medicaid-Funded Home- and Community-Based Services.

Abstract

This research determined how dementia status is associated with emergency department (ED) visits and hospitalizations among older adults receiving Medicaid-funded home- and community-based services (HCBS). We conducted a retrospective cohort study of HCBS enrollees in a single state aged 65 or older (N = 7,176). We linked clinical assessment data and up to 12 months of medical claims data following clinical assessment at the individual level. After controlling for covariates, we found no difference in ED use between those with and those without dementia. Individuals with dementia had a lower relative rate of hospitalizations than those without dementia (rate ratio = 0.90, p = 0.03). We conclude that dementia was not associated with an increase in ED visits and that dementia was associated with less hospital use, among older adults receiving Medicaid HCBS. More research is needed to understand how and why dementia confers no greater risk for ED and hospital use among Medicaid HCBS beneficiaries.