Household Members of Persons with Alzheimer's Disease: Health Conditions, Healthcare Resource Use, and Healthcare Costs

• Published in: Journal of the American Geriatrics Society (JAGS) 2014-03, Vol.62 (3), p.435-441
• Main Authors: Suehs, Brandon T., Shah, Sonali N., Davis, Cralen D., Alvir, Jose, Faison, Warachal E., Patel, Nick C., van Amerongen, Derek, Bobula, Joel
• Format: Article
• Language: English
• Subjects: Adult and adolescent clinical studies; Aged; Alzheimer Disease - economics; Alzheimer's disease; Biological and medical sciences; Caregivers; Cost of Illness; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Families & family life; Family Characteristics; Female; Follow-Up Studies; General aspects; Health Care Costs - statistics & numerical data; Health care expenditures; Health Resources - economics; Health Resources - utilization; Health services utilization; Health Status; healthcare costs; healthcare resource use; household members; Humans; Insurance Claim Review - economics; Male; Medical sciences; Medicare Part C - economics; Neurology; Organic mental disorders. Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; United States
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.12694

Objectives To compare medical condition burden, healthcare resource use, and healthcare costs of household members (HHMs) of individuals diagnosed with Alzheimer's disease (AD) with those of HHMs of matched individuals without AD. Design Retrospective cohort study based on administrative claims data collected between January 1, 2007, and December 31, 2011. Setting Medicare Advantage Prescription Drug (MAPD) plan. Participants MAPD plan members with a diagnosis of AD (International Classification of Disease Ninth Revision, Clinical Modification, code 331.0) were selected and linked to a HHM to form patient‐HHM dyads. AD dyads were matched to non‐AD dyads. Measurements Health‐related endpoints, including medical condition burden, healthcare resource use, and direct healthcare costs, were measured during 36 months of continuous health plan enrollment. Results Individuals with AD (n = 1,861) were linked to HHMs (n = 1,861), and these AD dyads were matched to 1,861 non‐AD patient–HHM dyads. AD HHMs had greater medical condition burden scores than non‐AD HHMs, with mood disorders, anxiety disorders, insomnia, substance abuse or dependence, cardiovascular disease, and rheumatoid arthritis being more prevalent in AD HHMs. Emergency department and outpatient service use were more common in AD HHMs than in non‐AD HHMs, and AD HHMs had greater healthcare costs. Conclusion HHMs of individuals diagnosed with AD demonstrated greater medical condition burden, healthcare resource use, and direct healthcare costs than non‐AD HHMs. These findings demonstrate the significant clinical and financial impact of AD on HHMs of individuals with AD.