TY - JOUR
T1 - Low-value care
T2 - antipsychotic medication use among community-dwelling medicare beneficiaries with Alzheimer’s disease and related dementias and without severe mental illness
AU - Nili, Mona
AU - Shen, Chan
AU - Sambamoorthi, Usha
N1 - Funding Information:
NIH Clinical Center. Research reported in this publication was partially supported by the National Institute of General Medical Sciences of the National Institutes of Health [grant number, 5U54GM104942-03]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/3/3
Y1 - 2020/3/3
N2 - Background: Antipsychotic medication use among elderly with Alzheimer’s disease and related dementias (ADRD) and without severe mental illness is considered as low-value care. Our objective was to assess the factors associated with this inappropriate use of antipsychotic medications among community-dwelling Medicare beneficiaries with ADRD and without severe mental illness. Methods: This study used a retrospective cross-sectional design. Data for this study were derived from the nationally representative Medicare Current Beneficiary Survey (MCBS) and linked Medicare claims. Logistic regression models were used to examine factors associated with low-value care. Results: Overall 8.5% had low-value care. In the final adjusted logistic regression model, race other than Hispanic or Non-Hispanic White (AOR =0.54, 95% CI = [0.30,0.98]), individuals over 80 years of age (AOR =0.53, 95% CI = [0.36,0.76]), and obese individuals (AOR =0.55, 95% CI = [0.35,0.85]) had significantly lower odds of receiving low-value care. Those with depression (AOR =1.71, 95% CI = [1.21, 2.43]), who lived in the Midwest (AOR =1.7, 95% CI = [1.08,2.68]), and with a higher number of ADL limitations (AOR =1.28, 95% CI = [1.19,1.38]) had significantly higher odds of low-value care. Conclusions: There were subgroup differences in low-value care. Interventions may target these subgroups to reduce low-value care.
AB - Background: Antipsychotic medication use among elderly with Alzheimer’s disease and related dementias (ADRD) and without severe mental illness is considered as low-value care. Our objective was to assess the factors associated with this inappropriate use of antipsychotic medications among community-dwelling Medicare beneficiaries with ADRD and without severe mental illness. Methods: This study used a retrospective cross-sectional design. Data for this study were derived from the nationally representative Medicare Current Beneficiary Survey (MCBS) and linked Medicare claims. Logistic regression models were used to examine factors associated with low-value care. Results: Overall 8.5% had low-value care. In the final adjusted logistic regression model, race other than Hispanic or Non-Hispanic White (AOR =0.54, 95% CI = [0.30,0.98]), individuals over 80 years of age (AOR =0.53, 95% CI = [0.36,0.76]), and obese individuals (AOR =0.55, 95% CI = [0.35,0.85]) had significantly lower odds of receiving low-value care. Those with depression (AOR =1.71, 95% CI = [1.21, 2.43]), who lived in the Midwest (AOR =1.7, 95% CI = [1.08,2.68]), and with a higher number of ADL limitations (AOR =1.28, 95% CI = [1.19,1.38]) had significantly higher odds of low-value care. Conclusions: There were subgroup differences in low-value care. Interventions may target these subgroups to reduce low-value care.
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U2 - 10.1080/13607863.2018.1544211
DO - 10.1080/13607863.2018.1544211
M3 - Article
C2 - 30521375
AN - SCOPUS:85058151553
SN - 1360-7863
VL - 24
SP - 504
EP - 510
JO - Aging and Mental Health
JF - Aging and Mental Health
IS - 3
ER -