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'Accountable Care' hospitals may assist rural Alzheimer's population

Journal of the American Geriatrics Society article examines challenges of rural caregiving

People with Alzheimer’s disease living in rural areas are much more likely to go to the emergency department (ED) for a preventable visit than their urban counterparts, a new study from the University of Maryland School of Public Health found. Faculty Associate Jie Chen led a team that included PhD candidates Nianyang Wang, the leading author, and Aitalohi Amaize to produce the research findings. They explored the rural and urban differences for older patients with Alzheimer’s disease and related dementias (ADRD) and the frequency of their preventable ED visits. (Preventable emergency department visits raise health care costs and reflect that people are not receiving the care needed to make such visits avoidable.)

Drawing on a sample of 117,196 individuals with Alzheimer's Disease or Related Dementia (ADRD), the team found that rural patients with ADRD had 1.13 higher adjusted odds (P = .007) of going to the ED for a preventable visit compared with their urban counterparts. In addition, Accountable Care Organization (ACO)‐affiliated hospitals had .91 lower adjusted odds (P = .005) of preventable ED visits for ADRD patients compared with hospitals not affiliated with an ACO. Whole‐county Mental Health Care Health Professional Shortage Area (HPSA) (odds ratio = 1.14; P = .002) designation was also an indicator of higher preventable ED rates.

Nianyang Wang MS, Aitalohi Amaize MPH, BSN, RN, Jie Chen PhD (2020). "Accountable Care Hospitals and Preventable Emergency Department Visits for Rural Dementia Patients." Journal of the American Geriatrics Society, first published 7 Oct 2020;