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55/100

✓ Peer-reviewed alzhub usefulness score 55 out of 100. Health systems and care delivery

Topic: Risk, prevention and care in population studies

Among 454,508 beneficiaries diagnosed with ADRD in 2017, 250,837 (55%) were in TM and 203,671 (45%) in MA. Four to 12 months before diagnosis, monthly hospitalizations and outpatient visits were similar in TM and MA. In the diagnosis month, 36.5% of beneficiaries in TM had a hospitalization compared with 25.4% in MA, an adjusted difference of 10.7 percentage points [95% CI: 10.3, 11.1]. Beneficiaries in TM averaged 10.5 outpatient visits in the diagnosis month compared with 8.4 in MA, an adjusted difference of 1.59 visits [95% CI: 1.47-1.70]. Utilization differences narrowed but remained higher in TM for many months. One-year mortality was 27.9% in TM and 22.2% in MA; an adjusted odds ratio of 1.152 [95% CI: 1.135-1.169] for those in TM compared with MA. Controlling for hospitalization in the diagnosis month substantially reduced the mortality difference. Hospitalization rates and outpatient visits increased more after an ADRD diagnosis in TM than MA. One-year post-diagnosis, mortality was not higher in MA than TM but comparisons of quality of life and caregiver burden are needed.

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

APA 7th

Jacobson, M., Ferido, P., & Zissimopoulos, J. (2023). Health care utilization before and after a dementia diagnosis in Medicare Advantage versus traditional Medicare. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.18570

Vancouver

Jacobson M, Ferido P, Zissimopoulos J. Health care utilization before and after a dementia diagnosis in Medicare Advantage versus traditional Medicare. Journal of the American Geriatrics Society. 2023. doi:10.1111/jgs.18570. PMID: 37668467.

BibTeX

@article{jacobson2023-37668467,
  author  = {Jacobson, Mireille and Ferido, Patricia and Zissimopoulos, Julie},
  title   = {{Health care utilization before and after a dementia diagnosis in Medicare Advantage versus traditional Medicare}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2023},
  doi     = {10.1111/jgs.18570},
  pmid    = {37668467},
  url     = {https://doi.org/10.1111/jgs.18570}
}

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Key findings

Among 454,508 beneficiaries diagnosed with ADRD in 2017, 250,837 (55%) were in TM and 203,671 (45%) in MA.
Four to 12 months before diagnosis, monthly hospitalizations and outpatient visits were similar in TM and MA.
In the diagnosis month, 36.5% of beneficiaries in TM had a hospitalization compared with 25.4% in MA, an adjusted difference of 10.7 percentage points [95% CI: 10.3, 11.1].
Beneficiaries in TM averaged 10.5 outpatient visits in the diagnosis month compared with 8.4 in MA, an adjusted difference of 1.59 visits [95% CI: 1.47-1.70].
Utilization differences narrowed but remained higher in TM for many months.

Why it matters

In 454,508 Medicare beneficiaries diagnosed with dementia in 2017, hospital and outpatient use looked similar in traditional Medicare and Medicare Advantage in the months before diagnosis. In the diagnosis month, though, 36.5% of traditional Medicare enrollees were hospitalized versus 25.4% in Medicare Advantage, and use stayed higher in traditional Medicare for many months. One-year mortality was also higher in traditional Medicare (27.9% vs 22.2%), but much of that gap tracked hospitalization at diagnosis. The authors say quality of life and caregiver burden still need to be compared before judging which plan serves people with dementia better.

Study details

Study designcohort study
Effect size36.5%; 25.4%; 27.9%
Evidence strengthModerate

How this study scored 55/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society)
Journal's citation record	3 / 4	Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	3 / 5	2023 — within 6 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	2 / 3	Effect reported as a number, without an interval or test
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	3 / 7	Cited 19 times (OpenAlex, 2026-10-10)
Citations per year	2 / 5	3.8 citations a year over 5 year(s) since 2023
Impact for its field and year	3 / 6	Cited 3.4× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 7 other studies in this library
Still being cited	2 / 4	Cited 18 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Julie Zissimopoulos: h-index 36 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Southern California: institution h-index 1,521 (OpenAlex)
Multi-centre collaboration	0 / 3	OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 37668467)
Free to read	2 / 2	Free to read
Total	55 / 100	—

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