Carolyn W Zhu1, Nikolaos Scarmeas2, Katherine Ornstein3, Marilyn Albert4, Jason Brandt5, Deborah Blacker6, Mary Sano7, Yaakov Stern2. 1. Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA. Electronic address: carolyn.zhu@mssm.edu. 2. Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA. 3. Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA; Division of General Internal Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. 4. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA. 5. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA; The Copper Ridge Institute, Sykesville, MD, USA. 6. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 7. Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA; James J. Peters VA Medical Center, Bronx, NY, USA.
Abstract
OBJECTIVE: To examine the effects of caregiver and patient characteristics on caregivers' medical care use and cost. METHODS: One hundred forty-seven caregiver/patient dyads were followed annually for 6 years in three academic Alzheimer's disease centers in the United States. Logistic, negative binomial, and generalized linear mixed models were used to examine overall effects of caregiver/patient characteristics on caregivers' hospitalizations, doctor visits, outpatient tests and procedures, and prescription and over-the-counter medications. RESULTS: Patients' comorbid conditions and dependence were associated with increased health-care use and costs of caregivers. Increases in caregiver depressive symptoms are associated with increases in multiple domains of caregivers' health-care use and costs. DISCUSSION: Findings suggest expanding our focus on dementia patients to include family caregivers to obtain a fuller picture of effects of caregiving. Primary care providers should integrate caregivers' needs in health-care planning and delivery. Clinical interventions that treat patients and caregivers as a whole will likely achieve the greatest beneficial effects.
OBJECTIVE: To examine the effects of caregiver and patient characteristics on caregivers' medical care use and cost. METHODS: One hundred forty-seven caregiver/patient dyads were followed annually for 6 years in three academic Alzheimer's disease centers in the United States. Logistic, negative binomial, and generalized linear mixed models were used to examine overall effects of caregiver/patient characteristics on caregivers' hospitalizations, doctor visits, outpatient tests and procedures, and prescription and over-the-counter medications. RESULTS:Patients' comorbid conditions and dependence were associated with increased health-care use and costs of caregivers. Increases in caregiver depressive symptoms are associated with increases in multiple domains of caregivers' health-care use and costs. DISCUSSION: Findings suggest expanding our focus on dementiapatients to include family caregivers to obtain a fuller picture of effects of caregiving. Primary care providers should integrate caregivers' needs in health-care planning and delivery. Clinical interventions that treat patients and caregivers as a whole will likely achieve the greatest beneficial effects.
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