Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA.
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Appl Gerontol. 2024 May;43(5):601-611. doi: 10.1177/07334648231213747. Epub 2023 Nov 14.
We assessed the spatiotemporal patterns of hospitalization with comorbid cancer and dementia. Using the 2013-2018 inpatient claims data for Medicare fee-for-service (FFS) beneficiaries, we calculated hospitalization rates by dividing the total admissions from individuals with the co-presence of a major cancer (breast, prostate, lung, and colorectal) and dementia diagnoses with the total counts of FFS beneficiaries aged 65 or older. We identified 22 hotspots with high hospitalization rates that showed heterogeneous spatial and temporal utilization patterns. The odds of a county being a hotspot increased significantly with the county-level percentage of dual Medicare-Medicaid beneficiaries (aOR 1.05; 95% CI: 1.04-1.07) and the prevalence of cancer (aOR 1.73; 95% CI: 1.59-1.89), while decreased significantly with increasing degree of rurality (aOR .82; 95% CI: .79-.85) and decreased yearly over time (aOR .72; 95% CI: .68-.75). The identified hotspots and factors at the county-level may help understand healthcare utilization patterns and assess resource allocation for this unique patient group.
我们评估了伴有癌症和痴呆的住院患者的时空模式。使用 2013-2018 年医疗保险按服务付费（FFS）受益人的住院数据，我们通过将同时患有主要癌症（乳腺癌、前列腺癌、肺癌和结直肠癌）和痴呆诊断的个体的总入院人数除以 65 岁或以上的 FFS 受益人的总人数来计算住院率。我们确定了 22 个具有高住院率的热点地区，这些地区表现出不同的空间和时间利用模式。一个县成为热点的可能性随着该县的医疗保险-医疗补助双重受益人的比例（优势比 1.05；95%置信区间：1.04-1.07）和癌症的流行率（优势比 1.73；95%置信区间：1.59-1.89）的增加而显著增加，而随着农村化程度的提高（优势比.82；95%置信区间：.79-.85）和每年的下降（优势比.72；95%置信区间：.68-.75）而显著下降。在县一级确定的热点地区和因素可能有助于了解这一独特患者群体的医疗保健利用模式，并评估资源分配情况。
