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Preventive medicine · Oct 2022
Rural and urban disparities in potentially preventable hospitalizations among US patients with Alzheimer's Disease and Related Dementias: Evidence of hospital-based telehealth and enabling services.
- Nianyang Wang, Portia Buchongo, and Jie Chen.
- Department of Health Policy and Management, University of Maryland School of Public Health, 4200 Valley Dr, College Park, MD 20742, USA.
- Prev Med. 2022 Oct 1; 163: 107223107223.
AbstractWe examined urban and rural disparities in potentially preventable hospitalizations (PPHs) among US patients with Alzheimer's Disease and Related Dementias (ADRD) and the use of telehealth post-discharge and enabling services as mediators. We merged 2017 100% Medicare Fee-For-Service (FFS) claims with the Medicare Beneficiary Summary File, along with population and hospital-based characteristics. Logistic regression models were employed to examine differences in PPHs by telehealth and enabling services. The rates of PPHs related to acute and chronic conditions for patients with ADRD living in rural and micropolitan areas were significantly higher compared to patients with ADRD in urban areas. Telehealth post-discharge combined with enabling services significantly decreased the odds of PPHs associated with acute (OR: 0.93, 95% CI: 0.89-0.98, P-value <0.01) and chronic conditions (OR: 0.96, 95% CI: 0.92-1.00, P-value = 0.07). In addition, telehealth post-discharge combined with enabling services significantly decreased the odds of PPHs in patients with ADRD in rural (acute PPHs OR: 0.56, 95% CI: 0.41-0.77, P-value <0.01; chronic PPHs OR: 0.73, 95% CI: 0.55-0.97, P-value = 0.03) and micropolitan (acute PPHs OR: 0.65, 95% CI: 0.57-0.73, P-value <0.01; chronic PPHs OR: 0.83, 95% CI: 0.74-0.93, P-value <0.01) areas. Our results suggest that the combinations of telehealth post-discharge and enabling services are important interventions in helping to reduce preventable hospitalizations among patients with ADRD living in rural and micropolitan areas.Copyright © 2022 Elsevier Inc. All rights reserved.
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