Objective: To evaluate incremental hospitalizations and costs among Medicare patients with Parkinson’s disease psychosis (PDP) vs. PDP+dementia (PDP+D).
Background: Research examining hospitalizations and costs of co-existing dementia (PDP+D) among patients with PDP are lacking.
Method: A retrospective analysis of patients with PDP using Parts A, B, and D claims from the 100% Medicare sample (01/01/13-12/31/19) was conducted. Patients with PDP and incident dementia (PDP+D) and without incident dementia (PDP) between 01/01/14 to 12/31/18 were selected. Patients with a pre-index diagnosis of dementia, psychosis, secondary parkinsonism, delirium, other psychotic disorders, alcohol/drug-induced psychosis, schizophrenia, paranoia, or personality disorder were excluded. PDP+D vs. PDP patients were 1:1 propensity score matched (PSM) using 31 variables (age, sex, race, region and 27 Elixhauser comorbidity characteristics). Post-index outcomes in the 1-year follow-up included: rates and mean per patient per year (PPPY) costs of all-cause inpatient (IP) hospitalizations, and by type of IP stay (i.e., short-term [ST-stay], skilled nursing facility [SNF-stay] and long-term [LT-stay]). Differences in all-cause hospitalizations and mean PPPY costs were examined using logistic and gamma log-link regression models, respectively.
Results: From patients with PDP+D (n=14,194) vs. PDP (n=2,449), PSM-matched cohorts (n=1,855 in each) were identified. Mean age, gender, and comorbidities were similar in PSM groups. Approximately, 50.3% with PDP+D reported ≥1 all-cause IP hospitalizations vs. 36.0% with PDP (p<0.05). Specifically, all-cause ST-stay, SNF-stay, and LT-stay among PDP+D vs. PDP patients were: 45.2% vs. 35.7%, 28.3% vs. 15.7%, and 8.5% vs. 6.0% (p<0.05), respectively. Mean PPPY IP hospitalization costs for PDP+D patients vs. PDP patients was $17,891(±29,882) vs $11,599 (±$25,247) (p<0.05). Mean PPPY costs among patients with PDP+D vs. PDP were: $6,700 (±14,409) vs. $3,385 (±10,056) for SNF-stays and $9,394 (±18,360) vs. $6,856 (±16,339) for ST-stays, respectively (p<0.05). No differences in mean PPPY LT-stay costs were seen.
Conclusion: In this analysis, patients with PDP+D reported 54% greater mean PPPY IP hospitalization costs and nearly two times greater mean PPPY SNF-stay costs vs. patients with PDP.
To cite this abstract in AMA style:
N. Rashid, K. Rajagopalan, D. Gopal, D. Doshi. Incremental Hospitalizations and Associated Costs of Co-existing Dementia in Patients with Parkinson’s Disease Psychosis: An analysis of US Medicare Beneficiaries [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/incremental-hospitalizations-and-associated-costs-of-co-existing-dementia-in-patients-with-parkinsons-disease-psychosis-an-analysis-of-us-medicare-beneficiaries/. Accessed September 7, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/incremental-hospitalizations-and-associated-costs-of-co-existing-dementia-in-patients-with-parkinsons-disease-psychosis-an-analysis-of-us-medicare-beneficiaries/