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痴呆症患者的风险因素与住院费用:探究种族和性别差异

Risk Factors and Hospitalization Costs of Dementia Patients: Examining Race and Gender Variations.

作者信息

Husaini Baqar, Gudlavalleti Aashrai Sv, Cain Van, Levine Robert, Moonis Majaz

机构信息

Center for Prevention Research, Tennessee State University, Nashville, Tennessee, USA.

Department of Neurology, University of Massachusetts, Massachusetts, USA.

出版信息

Indian J Community Med. 2015 Oct-Dec;40(4):258-63. doi: 10.4103/0970-0218.164396.

Abstract

AIMS

To examine the variation in risk factors and hospitalization costs among four elderly dementia cohorts by race and gender.

MATERIALS AND METHODS

The 2008 Tennessee Hospital Discharged database was examined. The prevalence, risk factors and cost of inpatient care of dementia were examined for individuals aged 65 years and above, across the four race gender cohorts - white males (WM), black males (BM), white females (WF), and black females (BF).

RESULTS

3.6% of patients hospitalized in 2008 had dementia. Dementia was higher among females than males, and higher among blacks than whites. Further, BF had higher prevalence of dementia than WF; similarly, BM had a higher prevalence of dementia than WM. Overall, six risk factors were associated with dementia for the entire sample including HTN, DM, CKD, CHF, COPD, and stroke. These risk factors varied slightly in predicting dementia by race and gender. Hospital costs were 14% higher among dementia patients compared to non-dementia patients.

CONCLUSIONS

There exist significant race and gender disparities in prevalence of dementia. A greater degree of co-morbidity, increased duration of hospital stay, and more frequent hospitalizations, may result in a higher cost of inpatient dementia care. Aggressive management of risk factors may subsequently reduce stroke and cost of dementia care, especially in the black population. Race and gender dependent milestones for management of these risk factors should be considered.

摘要

目的

按种族和性别研究四个老年痴呆队列中危险因素及住院费用的差异。

材料与方法

对2008年田纳西州医院出院数据库进行分析。针对65岁及以上的个体,在白人男性(WM)、黑人男性(BM)、白人女性(WF)和黑人女性(BF)这四个种族性别队列中,研究痴呆症的患病率、危险因素及住院护理费用。

结果

2008年住院患者中有3.6%患有痴呆症。女性痴呆症患病率高于男性,黑人高于白人。此外,黑人女性(BF)的痴呆症患病率高于白人女性(WF);同样,黑人男性(BM)的痴呆症患病率高于白人男性(WM)。总体而言,整个样本中有六个危险因素与痴呆症相关,包括高血压(HTN)、糖尿病(DM)、慢性肾病(CKD)、充血性心力衰竭(CHF)、慢性阻塞性肺疾病(COPD)和中风。这些危险因素在按种族和性别预测痴呆症方面略有差异。痴呆症患者的住院费用比非痴呆症患者高14%。

结论

痴呆症患病率存在显著的种族和性别差异。更高程度的合并症、更长的住院时间和更频繁的住院,可能导致痴呆症住院护理费用更高。积极管理危险因素可能随后降低中风及痴呆症护理费用,尤其是在黑人人群中。应考虑针对这些危险因素管理的种族和性别相关指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a66/4581146/5e34744d0fa2/IJCM-40-258-g002.jpg

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