Medical costs of Alzheimer's disease misdiagnosis among US Medicare beneficiaries

• DOI: 10.1016/j.jalz.2015.06.1889
• Publication Date: 2015-07-21T03:38:05Z
• Authors: Craig A. Hunter; Noam Y. Kirson; Urvi Desai; Alice Kate G. Cum...; Douglas E. Faries; Howard G. Birnbaum
• Keywords: Male; Epidemiology; Parkinson's disease; Misdiagnosis; Clinical Neurology; Medicare; Vascular dementia; Sensitivity and Specificity; Cohort Studies; Cellular and Molecular Neuroscience; 03 medical and health sciences; 0302 clinical medicine; Developmental Neuroscience; Alzheimer Disease; Outcome Assessment, Health Care; Humans; Diagnostic Errors; Aged; Aged, 80 and over; Health Policy; Dementia, Vascular; Health Care Costs; Alzheimer's disease; United States; 3. Good health; Psychiatry and Mental health; Economic impact; Logistic Models; Female; Geriatrics and Gerontology

AbstractIntroductionRecent developments in diagnostic technology can support earlier, more accurate diagnosis of non‐Alzheimer's disease (AD) dementias.MethodsTo evaluate potential economic benefits of early rule‐out of AD, annual medical resource use and costs for Medicare beneficiaries potentially misdiagnosed with AD prior to their diagnosis of vascular dementia (VD) or Parkinson's disease (PD) were compared with that of similar patients never diagnosed with AD.ResultsPatients with prior AD diagnosis used substantially more medical services every year until their VD/PD diagnosis, resulting in incremental annual medical costs of approximately $9,500‐$14,000. However, following their corrected diagnosis, medical costs converged with those of patients never diagnosed with AD.DiscussionThe observed correlation between timing of correct diagnosis and subsequent reversal in excess costs is strongly suggestive of the role of misdiagnosis of AD ‐ rather than AD comorbidity ‐ in this patient population. Our findings suggest potential benefits from earlier, accurate diagnosis.