TY  - JOUR
T1  - MEdicare expenditures among nursing home residents with advanced dementia
AU  - Goldfeld KS, Stevenson DG, Hamel M, Mitchell SL
Y1  - 2011/05/09
N1  - 10.1001/archinternmed.2010.478
JO  - Archives of Internal Medicine
SP  - 824
EP  - 830
VL  - 171
IS  - 9
N2  - 
Although 70% of persons with dementia die in nursing homes (NHs),3 most research describing health care spending for these individuals has been conducted in the community setting, and almost none has focused on end-stage disease. For Americans older than 65 years, Medicare covers the costs of acute care, subacute care, physician and other provider services, hospice, prescription drugs, and diagnostic tests. Medicare does not cover NH care, which is generally paid for by Medicaid after individuals exhaust their own resources. The total Medicare and Medicaid payments for patients with dementia are roughly 3 times higher than for age-matched controls.2,4 Total direct costs increase substantially over the course of the disease, with much of the increase in the later stages attributable to spending for NH care.5 Although per diem Medicaid payments account for most public spending within the NH setting, limited data suggest that Medicare expenditures explain most of the spending variation among dying residents with dementia.6 How this spending breaks down across the various Medicare services has not been well described.

SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2010.478
UR  - http://dx.doi.org/10.1001/archinternmed.2010.478
ER  -