Unnecessary end-stage dementia treatments increase Medicare costs, researchers say

A significant portion of Medicare expenditures for dementia residents in nursing homes is spent on aggressive treatments that could have little clinical benefit, according to a new study conducted by the Institute for Aging Research.

Researchers reviewed Medicare expenditures for 323 advanced dementia patients in Boston-area nursing homes and found that Medicare expenditures grew by 65% in the four quarters preceding death. They found that 30.2% of Medicare expenditures were for hospitalizations and 45.6% were for hospice. End-stage dementia patients are often needlessly subjected to hospital stays, believes lead researcher, Dr. Susan Mitchell. She said many treatments could be adequately handled in a nursing-home setting because hospital stays can be traumatic for dementia patients.

“Our study demonstrates that a large proportion of Medicare expenditures in advanced dementia are attributable to acute and sub-acute services that may be avoidable [as many as 75%] and may not improve clinical outcomes,” Mitchell said.

The study was published Jan. 10 in the online version of the Archives of Internal Medicine.