Health
More awareness and more detailed health records may explain the rise. End-of-life care shift-ScienceDaily as diagnosis allows for more advance planning
According to a new study, almost half of all older people now die from the diagnosis of dementia described in medical records, an increase of 36% from 20 years ago.
However, the sharp rise may be more related to better public awareness, more detailed medical records, and Medicare billing practices than the rise in actual conditions, researchers said. increase.
Nonetheless, this provides an opportunity for more older people to discuss in advance with their families and healthcare providers what kind of care they want at the end of their lives if they develop Alzheimer’s disease or other forms of cognitive decline. They say.
Research published in JAMA Health Forum According to a team at the University of Michigan, we use data from 3.5 million people aged 67 and over who died between 2004 and 2017. It focuses on invoices submitted by healthcare providers to traditional Medicare systems over the last two years of the patient.
In 2004, about 35% of these end-of-life claims contained at least one mention of dementia, but by 2017 it had risen to more than 47%. Even when researchers narrowed it down to patients with at least two medical claims mentioning dementia, 39% of patients increased from 25% in 2004.
The largest surge in the proportion of people dying from dementia diagnoses occurred around the time Medicare allowed hospitals, hospice, and clinics to list more diagnoses in their payment requests.
However, around this time, national plans to combat Alzheimer’s disease also came into force, focusing on public awareness, quality of care, and more support for patients and their caregivers.
End-of-life care received by people with dementia is somewhat over time, including a decline in the proportion of people who have died in regular hospital beds or ICU beds, or who have had feeding tubes in the last 6 months. It has changed. The percentage of people receiving hospice services has risen dramatically from 36% to nearly 63%, which is consistent with the national trend towards increased hospice care by the late 2010s, the authors say.
“This shows that we need to actively work on end-of-life care preferences with recently diagnosed people and their families,” said the senior author of the study, Geriatrics in Michigan Medicine. “Once the diagnosis may have been inadequate, we can now focus on how to use the dementia diagnosis rate, from national budget plans to adjusting how Medicare reimburses Medicare Advantage plans. . “
In addition to Bynum, the authors of this study are Dr. Matthew Davis of UM School of Nursing Medicine, Dr. Chiang-Hua Chang of the Department of Geriatrics and Palliative Medicine, and Dr. Sharon Simonton (MPH). Bynum, Davis and Chang are members of the UM Institute for Healthcare Policy and Innovation. Bynum and Davis are leaders in the Center for Accelerating Alzheimer’s Disease Census (CAPRA).
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