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Dementia patients face burdensome transitions in last 90 days
Date:9/28/2011

burdensome transitions. The authors, who also include researchers from Harvard University and Dartmouth College, found that the overall percentage of patients experiencing at least one burdensome transition was 19 percent. State-level rates varied from 2.1 percent in Alaska to 37.5 percent in Louisiana.

"These burdensome transitions are not only bad for the patient, they also drain the federal treasury, hastening the day when the Medicare trust fund runs out of money," said economist Jonathan Skinner from Dartmouth College, a co-author on the study.

A state-by-state report of the rate of burdensome transitions is available from Brown University at www.LTCFocUS.org.

Blacks and Hispanics were also more likely than whites to experience burdensome transitions, the authors found.

Amiss before dying

To reach these conclusions, the team analyzed federal databases of nursing home and Medicare records accumulated between 2000 and 2007. In all, they found 474,829 patients who were older than 66, had advanced cognitive impairment, and lived in a nursing home 120 days before their death. Of these, 90,228 residents experienced at least one burdensome transition, defined as either a transfer in the last three days of life, returning to a different nursing home than the one they lived in before they went to the hospital, or multiple hospitalizations in the last 90 days of life.

Often these hospitalizations occur even though the condition prompting the hospitalization pneumonia, urinary tract infection, or dehydration could easily be treated in a properly equipped and staffed nursing home.

These variations were particularly wide across different geographic areas. In McAllen, Texas, 25.8 percent of patients had multiple hospitalizations for urinary tract infections, pneumonia or dehydration, compared to only 1.1 percent of patients in Grand Junction, Colo.

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Contact: David Orenstein
david_orenstein@brown.edu
401-527-2525
Brown University
Source:Eurekalert

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