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50/100

✓ Peer-reviewed alzhub usefulness score 50 out of 100. Health systems and care delivery

Topic: Risk, prevention and care in population studies

The study cohort included 1 415 265 long-stay nursing home residents with dementia who died between 2013 and 2022. The unadjusted hospitalization rate in the last 30 days of life was 27.7%. UHC I-SNP enrollment was associated with a 9.0-percentage point (pp) reduction in hospitalization (95% CI, -10.3 pp to -7.7 pp) while non-UHC I-SNP enrollment was associated with a 5.9-pp reduction (95% CI, -8.4 pp to -3.5 pp). The spillover effect on nonenrollees in nursing homes offering a UHC I-SNP was a 1.7-pp (95% CI, -2.4 pp to -1.1 pp) decline in hospitalizations; the spillover effect in non-UHC nursing homes was not statistically significant. Similar trends appeared with hospitalization in the last 3 days of life, intensive care unit admission, and mechanical ventilation, but there was no association with hospice use. The reduction in hospitalizations increased in the 3 years after nursing home I-SNP adoption, then plateaued. Conclusions and Relevance: In this retrospective cohort study, I-SNP enrollment was associated with significantly fewer hospitalizations for nursing home residents with dementia at the end of life, with effect sizes larger for UHC vs non-UHC I-SNPs. Plan maturity and volume are likely important factors impacting success.

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

APA 7th

White, E. M., Gozalo, P. L., Santostefano, C. M., Kosar, C. M., McGarry, B. E., Geng, F., et al. (2026). Institutional Special Needs Plans and End-of-Life Outcomes for Nursing Home Residents With Dementia. JAMA Health Forum. https://doi.org/10.1001/jamahealthforum.2026.1649

Vancouver

White EM, Gozalo PL, Santostefano CM, Kosar CM, McGarry BE, Geng F, et al. Institutional Special Needs Plans and End-of-Life Outcomes for Nursing Home Residents With Dementia. JAMA Health Forum. 2026. doi:10.1001/jamahealthforum.2026.1649. PMID: 42218737.

BibTeX

@article{white2026-42218737,
  author  = {White, Elizabeth M. and Gozalo, Pedro L. and Santostefano, Christopher M. and Kosar, Cyrus M. and McGarry, Brian E. and Geng, Fangli and Zorowitz, Robert A. and Grabowski, David C. and others},
  title   = {{Institutional Special Needs Plans and End-of-Life Outcomes for Nursing Home Residents With Dementia}},
  journal = {JAMA Health Forum},
  year    = {2026},
  doi     = {10.1001/jamahealthforum.2026.1649},
  pmid    = {42218737},
  url     = {https://doi.org/10.1001/jamahealthforum.2026.1649}
}

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Key findings

The study cohort included 1 415 265 long-stay nursing home residents with dementia who died between 2013 and 2022.
The unadjusted hospitalization rate in the last 30 days of life was 27.7%.
UHC I-SNP enrollment was associated with a 9.0-percentage point (pp) reduction in hospitalization (95% CI, -10.3 pp to -7.7 pp) while non-UHC I-SNP enrollment was associated with a 5.9-pp reduction (95% CI, -8.4 pp to -3.5 pp).
The spillover effect on nonenrollees in nursing homes offering a UHC I-SNP was a 1.7-pp (95% CI, -2.4 pp to -1.1 pp) decline in hospitalizations; the spillover effect in non-UHC nursing homes was not statistically significant.
Similar trends appeared with hospitalization in the last 3 days of life, intensive care unit admission, and mechanical ventilation, but there was no association with hospice use.

Why it matters

This study found that nursing home residents with dementia who were enrolled in certain Medicare Advantage special needs plans were less likely to be hospitalized near the end of life. It is about end-of-life care and hospital use, not about treating, curing, or preventing Alzheimer's disease itself.

Study details

Study designcohort study
Effect size27.7%
Evidence strengthModerate

How this study scored 50/100

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 randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (JAMA Health Forum)
Journal's citation record	0 / 4	JAMA Health Forum: journal h-index 60 (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	5 / 5	2026 — within 1 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)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	1 / 7	Cited 1 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.5 citations a year over 2 year(s) since 2026
Impact for its field and year	4 / 6	Cited 8.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Momotazur Rahman: h-index 35 (OpenAlex, whole career)
Institution's track record	3 / 3	Harvard University: institution h-index 3,235 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 5 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 42218737)
Free to read	2 / 2	Free to read
Total	50 / 100	—

What each of these 20 components measures, and what this score is not →

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