Racial/Ethnic Disparities in Misidentification of Dementia in Medicare Claims: Results from the Washington Heights-Inwood Columbia Aging Project.
J Alzheimers Dis
; 96(1): 359-368, 2023.
Article
in En
| MEDLINE
| ID: mdl-37781805
ABSTRACT
BACKGROUND:
Misidentification of dementia in Medicare claims is quite common.OBJECTIVE:
We examined potential race/ethnic disparities in misidentification of dementia in Medicare claims in a diverse cohort of older adults who underwent careful clinical assessment.METHODS:
Participants were enrolled in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multiethnic, population-based, prospective study of cognitive aging in which dementia status was assessed using a rigorous clinical protocol. ICD-9-CM and ICD-10-CM diagnosis codes in all available Medicare claims (1999-2019) were compared to clinical dementia diagnosis and categorized into three mutually exclusive groups 1) congruent-, 2) over-, and 3) under- identification during the study period. Multinomial logistic regression model was used to examine the relationship between race (White, African American/Black, other) and ethnicity (Hispanic/Latinx, non-Hispanic/Latinx) and congruency of dementia identification after controlling for clinical (cognition, function, comorbidities) and demographic characteristics (age, sex, education), and inpatient and outpatient utilization.RESULTS:
Across all person-years, 88.4% had congruent identification of dementia compared to clinical diagnosis, in 4.1% of the times participants were over-identified with dementia, and 7.5% of the times the participants were under-identified. Rates of misidentification was higher in minority participants than in White, non-Hispanic participants. Multivariable estimation results showed that the probability of over-identification with dementia was 2.2% higher for African American/Black than White (pâ=â0.05) and 2.7% higher for Hispanic participants than non-Hispanics (pâ=â0.03) participants. Differences in under-identification by race/ethnicity were not statistically significant.CONCLUSIONS:
African American/Black and Hispanic participants were more likely over-identified with dementia in Medicare claims.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Medicare
/
Dementia
Type of study:
Guideline
/
Observational_studies
/
Prognostic_studies
Limits:
Aged
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
J Alzheimers Dis
Journal subject:
GERIATRIA
/
NEUROLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Estados Unidos