ArticleJournal of the American Geriatrics Society2022
Medicare-funded home-based clinical care for community-dwelling persons with dementia: An essential healthcare delivery mechanism.
Article in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 33 citations in OpenAlex.
- Assessing the Effects of Home-Based Primary Care on Alzheimer's Caregivers and Support Organizations: An Application of the Health Equity Implementation Framework.Qualitative health research · 2026Article
- Quality of Medicare Skilled Home Health for People Living With Dementia in the US: National Patterns and Implications.Journal of the American Geriatrics Society · 2026Article
- Sources of inequality in "living well" with dementia: an intersectional analysis using a British cohort study.Innovation in aging · 2026Article
- Understanding how social context shapes decisions to seek institutional care: a qualitative study of experiences of progressive cognitive decline among Latinx families.The Gerontologist · 2025Article
- Niece and nephew dementia caregivers: family relationships and care dynamics.The Gerontologist · 2025Article
- The dementia care workforce: Essential to care but large research gaps exist.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- Clinician type and care setting for treatment of Medicare beneficiaries with dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Skilled home healthcare utilization and outcomes for older adults with dementia: A scoping review.Journal of the American Geriatrics Society · 2025Article
- Patterns of national emergency department utilization by fee-for-service Medicare beneficiaries with dementia.Journal of the American Geriatrics Society · 2024Article
- How do care partners overcome the challenges associated with falls of community-dwelling older people with dementia? A qualitative study.Dementia (London, England) · 2024Article
- Dementia Care in Rural Appalachia: Multilevel Analysis of Individual- and County-Level Factors.The Gerontologist · 2024Article
- Healthcare contact days among older adults living with dementia.Journal of the American Geriatrics Society · 2024Article
- Drivers of Community-Entry Home Health Care Utilization Among Older Adults.Journal of the American Medical Directors Association · 2024Article
- Place of care in the last three years of life for Medicare beneficiaries.BMC geriatrics · 2024Article
- Care Setting Transitions for People With Dementia: Qualitative Perspectives of Current and Former Care Partners.The American journal of hospice & palliative care · 2023Article
- County-Level Social Vulnerability, Metropolitan Status, and Availability of Home Health Services.JAMA network open · 2023Article
- Home health services for minorities in urban and rural areas with Alzheimer's and related dementia.Home health care services quarterly · 2023Article
- Examining the role of race and quality of home health agencies in delayed initiation of home health services for individuals with Alzheimer's disease and related dementias (ADRD).Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults.Journal of the American Medical Directors Association · 2023Article
- Prevalence of use and characteristics of users of home-based medical care in Medicare Advantage.Journal of the American Geriatrics Society · 2023Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundOver the past decade, medical care has shifted from institutions into home settings-particularly among persons with dementia. Yet it is unknown how home-based clinical services currently support persons with dementia, and what factors shape access.
methodsUsing the National Health and Aging Trends Study linked to Medicare claims 2012-2017, we identified 6664 community-dwelling adults age ≥ 70 years enrolled in fee-for-service Medicare. Annual assessment of dementia status was determined via self-report, cognitive interview, and/or proxy assessment. Receipt of four types of home-based clinical care (home-based medical care (HBMC) (i.e., nurse practitioner, physician, or physician assistant visits), skilled home health care (SHHC), podiatry visits, and other types of home-based clinical services (e.g., behavioral health)) was assessed annually. We compared age-adjusted rates of home-based clinical care by dementia status and determined sociodemographic, health, and environmental characteristics associated with utilization of home-based clinical care among persons with dementia.
resultsNearly half (44.4%) of persons with dementia received any home-based clinical care annually compared to only 14.4% of those without dementia. Persons with dementia received substantially more of each type of home-based clinical care than those without dementia including a 5-fold increased use of HBMC (95% CI = 3.8-6.2) and double the use of SHHC (95% CI = 2.0-2.5). In adjusted models, Hispanic/Latino persons with dementia were less likely to receive HBMC (OR = 0.32; 95% CI = 0.11-0.93). Use of HBMC, podiatry, and other home-based clinical care was significantly more likely among those living in residential care facilities, in the Northeast and in metropolitan areas.
conclusionAlthough almost half of community-dwelling persons with dementia receive home-based clinical care, there is significant variation in utilization based on race/ethnicity and environmental context. Increased understanding as to how these factors impact utilization is necessary to reduce potential inequities in healthcare delivery among the dementia population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.