2028. VA Utilization and
Costs for Long Term Care (LTC) Patients with Alzheimer’s Disease (AD)
L Wolfsfeld, Center for Health Quality, Outcomes and Economic
Research, S Zhu, Center for Health Quality, Outcomes and Economic
Research, A Hendricks, Center for Health Quality, Outcomes and Economic
Research
Objectives: To compare
utilization and costs for VA LTC patients with a diagnosis of AD with
utilization and costs of VA LTC patients as a whole, by VISN, age and LTC
program.
Methods: Using VA
nationwide utilization files (PTF, OPC, Census) for FY1998 to FY2000, we
identified all LTC patients with an AD diagnosis (ICD-9 code 331.0). Results are
stratified by inpatient and outpatient long term care program, age and VISN, by
year.
Results: In
FY2000, 4,247 LTC inpatients and 6315 LTC outpatients had an AD diagnosis.
The largest number (3,839) of LTC inpatients with an AD diagnosis
received care in VA nursing homes, but respite programs had the largest
percentage of patients (13.7%).
The largest number of LTC outpatients with an AD diagnosis received care
at geriatric clinics (3,842) while the Alzheimer’s/dementia and the adult day
health programs had the greatest proportionate number of AD patients (49% and
21.5% respectively). AD diagnoses increase with age.
For example, among LTC inpatients, 6.3% of 65-74 year olds, 14.2% of
75-84 year olds and 16.5% of 85+ year olds had an AD diagnosis. Across VISNs,
the percentage of LTC patients with AD varied from 2% to 12% for LTC inpatients
and from 2% to 27% for LTC outpatients. Mean
number of nursing home days for VA nursing home patients with a diagnosis of AD
was 132 compared to 111 days for all VA nursing home patients.
Nursing home costs for nursing home patients with a diagnosis of AD were
$38,385 per year compared to $32,256 per year for all nursing home patients.
Conclusions: Approximately
7% of VA LTC patients had a diagnosis of AD in FY2000. Almost 90% of LTC
inpatients with an AD diagnosis received VA nursing home care compared to 60% of
LTC inpatients overall. AD patients
comprised 9.7% of all nursing home patients and accounted for 11% of total
nursing home costs.