Evidence map›Paper›PMID 39223513›Full record

ArticleBMC geriatrics2024

Medical visits and mortality among dementia patients during the COVID-19 pandemic compared to rates predicted from 2019.

Kaushik Ghosh, Susan T Stewart, Trivellore Raghunathan, David M Cutler

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kaushik GhoshNational Bureau of Economic Research, Cambridge, MA, 02138, USA.
Susan T StewartNational Bureau of Economic Research, Cambridge, MA, 02138, USA. sstewart@nber.org.
Trivellore RaghunathanInstitute for Social Research and Department of Biostatistics, University of Michigan, Ann Arbor, MI, 48106, USA.
David M CutlerNational Bureau of Economic Research, Cambridge, MA, 02138, USA.

Funding

PA-20-072, Measuring the Clinical and Economic Outcomes Associated with Delivery Systems: "Are Health Systems Better at Responding to Pandemics?"U19HS024072 · AHRQ · NATIONAL BUREAU OF ECONOMIC RESEARCH · PI CUTLER, DAVID M · 2015 to 2021
$19.8M
Using Satellite National Health Accounts to Understand Health and Cost ChangesR37AG047312 · NIA · NATIONAL BUREAU OF ECONOMIC RESEARCH · PI CUTLER, DAVID M · 2015 to 2022
$5.3M
AHRQ HHS U19HS024072NIA NIH HHS R37AG047312
6 · The paper itself

Abstract

backgroundDuring the COVID-19 pandemic, patients with Alzheimer's disease and related dementias (ADRD) were especially vulnerable, and modes of medical care delivery shifted rapidly. This study assessed the impact of the pandemic on care for people with ADRD, examining the use of primary, emergency, and long-term care, as well as deaths due to COVID and to other causes.

methodsAmong 4.2 million beneficiaries aged 66 and older with ADRD in traditional Medicare, monthly deaths and claims for routine care (doctors' office and telehealth visits), inpatient/emergency department (ED) visits, and long-term care facility use from March or June 2020 through December 2022 are compared to monthly rates predicted from January-December 2019 using OLS and logistic/negative binomial regression. Correlation analyses examine the association between excess deaths - due to COVID and non-COVID causes - and changes in care use in the beneficiary's state of residence.

resultsIncreased telehealth visits more than offset reduced office visits, with primary care visits increasing overall (by 9 percent from June 2020 onward relative to the predicted rate from 2019, p < .001). Emergency/inpatient visits declined (by 9 percent, p < .001) and long-term care facility use declined, remaining 14% below the 2019 trend from June 2020 onward (p < .001). Both COVID and non-COVID deaths rose, with 231,000 excess deaths (16% above the prediction from 2019), over 80 percent of which were attributable to COVID. Excess deaths were higher among women, non-White patients, those in rural and isolated zip codes, and those with higher social deprivation index scores. States with the largest increases in primary care visits had the lowest excess deaths (correlation -0.49).

conclusionsOlder adults with ADRD had substantial deaths above pre-pandemic projections during the COVID-19 pandemic, 80 percent of which were attributed to COVID-19. Routine care increased overall due to a dramatic increase in telehealth visits, but this was uneven across states, and mortality rates were significantly lower in states with higher than pre-pandemic visits.

Indexed as

COVID-19DementiaTelemedicineAgedAged, 80 and overEmergency Service, HospitalFemaleHumansLong-Term CareMaleMedicareOffice VisitsPandemicsUnited StatesAlzheimer’sCOVID-19DeathsDementiaDoctor visitsEmergency careHealth care costsHealth care useInpatientLong-term careMedicareMortalityPrimary careTelehealth

Identifiers

PMID39223513
PMCPMC11367830

What Socratic holds

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LicenceCC BY
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Registered trials

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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.