Introduction
System-level care coordination strategies can be the most effective to promote continuity
of care among people with Alzheimer's disease; however, the evidence is lacking. The
objective of this study is to determine whether accountable care organizations are
associated with lower rates of potentially preventable hospitalizations for people
with Alzheimer's disease and whether hospital accountable care organization affiliation
is associated with reduced racial and ethnic disparities in preventable hospitalizations
among patients with Alzheimer's disease.
Methods
This study employed a cross-sectional study design and used 2015 Healthcare Cost and
Utilization Project inpatient claims data from 11 states and the 2015 American Hospital
Association Annual Survey. Logistic regression and the Blinder–Oaxaca decomposition
method were used.
Results
African American patients with Alzheimer's disease were less likely to be hospitalized
at accountable care organization‒affiliated hospitals than White patients. Among patients
with Alzheimer's disease who were hospitalized, hospital accountable care organization
affiliation was associated with lower odds of potentially preventable hospitalizations
(OR=0.86, p=0.02; OR=0.66, p<0.001 with propensity score matching) after controlling for patient characteristics,
hospital characteristics, and state indicators. Hospital accountable care organization
affiliation explained 3.01% (p<0.01) of the disparity in potentially preventable hospitalizations between White
and African American patients but could not explain disparities between White and
Latinx patients.
Conclusions
Evidence suggests that accountable care organizations may be able to improve care
coordination for people with Alzheimer's disease and to reduce disparities between
Whites and African Americans. Further research is needed to determine whether this
benefit can be attributed to accountable care organization formation or whether providers
that participate in accountable care organizations tend to provide higher-quality
care.
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Published online: April 05, 2021
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- Corrigendum: Disparities in Preventable Hospitalization Among Patients With Alzheimer Diseases. Chen J, Benjenk I, Barath D, Anderson AC, Reynolds CF III. Am J Prev Med. 2021;60(5):595−604.American Journal of Preventive MedicineVol. 62Issue 6
