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47/100

✓ Peer-reviewed alzhub usefulness score 47 out of 100. Disparities

Topic: Risk, prevention and care in population studies

It was hypothesized that race or ethnicity, social support, and functional status are independently associated with treatment intensity and controlling for regional characteristics, and that individual characteristics account for a substantial proportion of expenditure variation. Results Decline in function (rate ratio [RR], 1.64 [95% CI, 1.46 to 1.83]); Hispanic ethnicity (RR, 1.50 [CI, 1.22 to 1.85]); black race (RR, 1.43 [CI, 1.25 to 1.64]); and certain chronic diseases, including diabetes (RR, 1.16 [CI, 1.06 to 1.27]), were associated with higher expenditures. Nearby family (RR, 0.90 [CI, 0.82 to 0.98]) and dementia (RR, 0.78 CI, 0.71 to 0.87]) were associated with lower expenditures, and advance care planning had no association. Regional characteristics, including end-of-life practice patterns (RR, 1.09 [CI, 1.06 to 1.14]) and hospital beds per capita (RR, 1.01 [CI, 1.00 to 1.02]), were associated with higher expenditures. Patient characteristics explained 10% of overall variance and retained statistically significant relationships with expenditures after regional characteristics were controlled for.

Key findings

It was hypothesized that race or ethnicity, social support, and functional status are independently associated with treatment intensity and controlling for regional characteristics, and that individual characteristics account for a substantial proportion of expenditure variation.
Results Decline in function (rate ratio [RR], 1.64 [95% CI, 1.46 to 1.83]); Hispanic ethnicity (RR, 1.50 [CI, 1.22 to 1.85]); black race (RR, 1.43 [CI, 1.25 to 1.64]); and certain chronic diseases, including diabetes (RR, 1.16 [CI, 1.06 to 1.27]), were associated with higher expenditures.
Nearby family (RR, 0.90 [CI, 0.82 to 0.98]) and dementia (RR, 0.78 CI, 0.71 to 0.87]) were associated with lower expenditures, and advance care planning had no association.
Regional characteristics, including end-of-life practice patterns (RR, 1.09 [CI, 1.06 to 1.14]) and hospital beds per capita (RR, 1.01 [CI, 1.00 to 1.02]), were associated with higher expenditures.
Patient characteristics explained 10% of overall variance and retained statistically significant relationships with expenditures after regional characteristics were controlled for.

Why it matters

This study found that dementia was associated with lower medical expenditures in the last 6 months of life. It does not test any treatment, cure, or prevention for Alzheimer's disease.

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Study details

Evidence strengthLow

How this study scored 47/100

Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Annals of internal medicine)
Journal's citation record	4 / 4	Annals of Internal Medicine: journal h-index 648 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2011 — within 20 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	5 / 7	Cited 156 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	9.2 citations a year over 17 year(s) since 2011
Impact for its field and year	4 / 6	Cited 14.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	1 / 6	Cited by 2 other studies in this library
Still being cited	1 / 4	Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Catherine A. Sarkisian: h-index 44 (OpenAlex, whole career)
Institution's track record	2 / 3	University of California, Los Angeles: institution h-index 1,923 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 5 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 21320939)
Free to read	0 / 2	Behind a paywall — scores zero
Total	47 / 100	—

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Read the original

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

APA 7th

Kelley, A. S., Ettner, S. L., Morrison, R. S., Du, Q., Wenger, N. S., & Sarkisian, C. A. (2011). Determinants of medical expenditures in the last 6 months of life. Annals of internal medicine. https://doi.org/10.7326/0003-4819-154-4-201102150-00004

Vancouver

Kelley AS, Ettner SL, Morrison RS, Du Q, Wenger NS, Sarkisian CA. Determinants of medical expenditures in the last 6 months of life. Annals of internal medicine. 2011. doi:10.7326/0003-4819-154-4-201102150-00004. PMID: 21320939.

BibTeX

@article{kelley2011-21320939,
  author  = {Kelley, A. S. and Ettner, S. L. and Morrison, R. S. and Du, Q. and Wenger, N. S. and Sarkisian, C. A.},
  title   = {{Determinants of medical expenditures in the last 6 months of life}},
  journal = {Annals of internal medicine},
  year    = {2011},
  doi     = {10.7326/0003-4819-154-4-201102150-00004},
  pmid    = {21320939},
  url     = {https://doi.org/10.7326/0003-4819-154-4-201102150-00004}
}

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