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When context matters: social disparities in preventable hospitalizations among Medicare beneficiaries with dementia
Viktoryia A. Kalesnikava, Brian C. Madden, Nela Vugdalic, Paul Lin, Elham Mahmoudi. Innovation in Aging, 2026-01-01
Topic: Risk, prevention and care in population studies
One-third of hospitalizations were PPHs. Urinary tract infection (33.8%), heart failure (25.7%), and pneumonia (18.6%) accounted for 78% of all PPHs. Unadjusted PPH rates were higher in highly disadvantaged areas (23.9%) compared to low-disadvantaged areas (20.6%). In the overall sample, Black and Hispanic individuals had higher odds of PPH than White individuals, as did those in highly disadvantaged areas compared to low-disadvantaged areas. Among highly disadvantaged urban and rural-or-micropolitan area residents, adjusted PPH rates were 23% and 27%, respectively. Odds of PPH were markedly higher in highly disadvantaged rural-or-micropolitan areas compared with low-disadvantaged areas. Racial/ethnic disparities diminished in these areas, while risk increased for female adults compared with male adults. Discussion and The highest PPH risk occurred in highly disadvantaged rural-or-micropolitan areas. Although racial/ethnic disparities were attenuated in these populations, the overall PPH risk was elevated. Policy efforts should prioritize expanding access to ambulatory care in disadvantaged areas.
Key findings
- Urinary tract infection (33.8%), heart failure (25.7%), and pneumonia (18.6%) accounted for 78% of all PPHs.
- Unadjusted PPH rates were higher in highly disadvantaged areas (23.9%) compared to low-disadvantaged areas (20.6%).
- In the overall sample, Black and Hispanic individuals had higher odds of PPH than White individuals, as did those in highly disadvantaged areas compared to low-disadvantaged areas.
- Among highly disadvantaged urban and rural-or-micropolitan area residents, adjusted PPH rates were 23% and 27%, respectively.
- Odds of PPH were markedly higher in highly disadvantaged rural-or-micropolitan areas compared with low-disadvantaged areas.
Why it matters
This study found that potentially preventable hospitalizations among Medicare beneficiaries with dementia were more common in highly disadvantaged areas, especially rural-or-micropolitan ones. It points to expanding access to ambulatory care in disadvantaged areas, but reports no treatment, cure or prevention of Alzheimer's disease.
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Study details
- Effect size33.8%; 25.7%; 18.6%
- Evidence strengthModerate
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, 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 (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (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 | 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× 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 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Elham Mahmoudi: h-index 29 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42158460) |
| Free to read | 2 / 2 | Free to read |
| Total | 36 / 100 | — |
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Read the original
- DOI: 10.1093/geroni/igag035
- PubMed: 42158460
- Original source →
- Free full text: Innovation in Aging →
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. Check the citation against the original before you use it.
APA 7th
Kalesnikava, V. A., Madden, B. C., Vugdalic, N., Lin, P., & Mahmoudi, E. (2026). When context matters: social disparities in preventable hospitalizations among Medicare beneficiaries with dementia. Innovation in Aging. https://doi.org/10.1093/geroni/igag035
Vancouver
Kalesnikava VA, Madden BC, Vugdalic N, Lin P, Mahmoudi E. When context matters: social disparities in preventable hospitalizations among Medicare beneficiaries with dementia. Innovation in Aging. 2026. doi:10.1093/geroni/igag035. PMID: 42158460.
BibTeX
@article{kalesnikava2026-42158460,
author = {Kalesnikava, Viktoryia A. and Madden, Brian C. and Vugdalic, Nela and Lin, Paul and Mahmoudi, Elham},
title = {{When context matters: social disparities in preventable hospitalizations among Medicare beneficiaries with dementia}},
journal = {Innovation in Aging},
year = {2026},
doi = {10.1093/geroni/igag035},
pmid = {42158460},
url = {https://doi.org/10.1093/geroni/igag035}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.