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Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study
Peter S. Reed, Yonsu Kim, Jay J. Shen, Sai Harsha Kosaraju, Mingon Kang, Jennifer D. Carson, Iulia Ioanitoaia Chaudhry, Sarah Kim et al.. International Journal of Environmental Research and Public Health, 2025-09-07
Topic: Risk, prevention and care in population studies
Identifying strategies to enhance patient engagement and to control healthcare costs promotes a responsive and efficient healthcare system. The aim of this study is to predict healthcare cost savings associated with delivering telehealth advance care planning (ACP) to patients living with dementia. Two Geriatrics Workforce Enhancement Programs delivered training to primary care providers on using telehealth to provide ACP. Using electronic health records data from 6344 dual-eligible Medicare/Medicaid patients receiving telehealth primary care from trained providers in an urban safety net system, persons living with dementia (n = 401) were identified by extracting ICD-10 codes. The primary outcome was the estimated hospitalization-associated cost, with a key independent variable of ACP billing status. Multiple linear regressions and machine learning techniques estimated the impact of telehealth ACP on hospitalization-associated costs with a differential analysis by race. Compared to non-Hispanic Whites, hospitalization costs among Hispanic elders were higher by USD 14,232.40. Costs for non-English speakers or those having increased comorbidities were higher by USD 27,346.60 and USD 26,072.70, respectively. Overall, receiving ACP was associated with lower costs of USD 23,928.84. Dementia patients seen by primary care providers in a system receiving training to offer ACP via telehealth realized significant cost savings, with marked differences among those of non-White racial backgrounds.
Key findings
- The aim of this study is to predict healthcare cost savings associated with delivering telehealth advance care planning (ACP) to patients living with dementia.
- Compared to non-Hispanic Whites, hospitalization costs among Hispanic elders were higher by USD 14,232.40.
- Overall, receiving ACP was associated with lower costs of USD 23,928.84.
- Dementia patients seen by primary care providers in a system receiving training to offer ACP via telehealth realized significant cost savings, with marked differences among those of non-White racial backgrounds.
Why it matters
This cost prediction study estimated that receiving advance care planning by telehealth was linked to lower hospital costs for people with dementia, with differences by race. It does not test any treatment, cure or prevention.
Study details
- Participants401
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International Journal of Environmental Research and Public Health) |
| Journal's citation record | 3 / 4 | International Journal of Environmental Research and Public Health: journal h-index 320 (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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 401 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.7× 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 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Ji Won Yoo: h-index 25 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University of Nevada, Reno: institution h-index 514 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41007544) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3390/ijerph22091399
- PubMed: 41007544
- Original source →
- Free full text: International Journal of Environmental Research and Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Reed, P. S., Kim, Y., Shen, J. J., Kosaraju, S. H., Kang, M., Carson, J. D., et al. (2025). Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph22091399
Vancouver
Reed PS, Kim Y, Shen JJ, Kosaraju SH, Kang M, Carson JD, et al. Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study. International Journal of Environmental Research and Public Health. 2025. doi:10.3390/ijerph22091399. PMID: 41007544.
BibTeX
@article{reed2025-41007544,
author = {Reed, Peter S. and Kim, Yonsu and Shen, Jay J. and Kosaraju, Sai Harsha and Kang, Mingon and Carson, Jennifer D. and Chaudhry, Iulia Ioanitoaia and Kim, Sarah and others},
title = {{Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study}},
journal = {International Journal of Environmental Research and Public Health},
year = {2025},
doi = {10.3390/ijerph22091399},
pmid = {41007544},
url = {https://doi.org/10.3390/ijerph22091399}
}
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