AbstractBackgroundWith increasing life expectancy, cognitive impairments have become an important public health issue worldwide and in the U.S. Socioeconomically‐disadvantaged populations, including racial/ethnic minorities, are more vulnerable as they have higher rates of underlying conditions and cognitive impairments, such as Alzheimer’s disease and related dementia. With progressive impairments in cognition, behavior, and functionality, patients, families, and healthcare systems face challenges associated with healthcare, including increased costs of care for emergency department visits, hospitalizations, and revisit rates. Our purpose was to examine the relationships between sociodemographic variables and healthcare utilization in older adults with cognitive impairment.MethodThe Health and Retirement Study (HRS), Rand data (2014), were used to understand sociodemographic predictors of healthcare utilization (hospital stay days, nursing home days, home care days, and numbers of doctor’s visits). Due to the skewness of the data, we grouped each category for the length of healthcare utilization into never, short, medium, and long. Only those persons with dementia or impaired cognition were included.ResultOf the 3,924 older adults from the HRS sample, 22% had a diagnosis of dementia and 78% had impaired cognition. Ethnicity, education, and age were significantly associated with the length of hospital stay. Hispanics and those with lower education and younger were less likely to use long hospital stays than others. Ethnicity, marital status, gender, and age were predictors of nursing home length of stay. Blacks, Hispanics, men, and married and younger respondents were less likely to stay long in nursing homes. Blacks and younger respondents were less likely to have long home care utilization. Race, ethnicity, rurality, gender, education, and age were predictors of doctor’s visits. Blacks, Hispanics, rural residents, men, those with lower education, and younger had fewer doctor’s visits. Race, ethnicity, and education were consistent predictors across utilization types.ConclusionThis study provides evidence of the need to understand how older adults with cognitive impairments and multiple marginalized identities (i.e., age, gender, race, ethnicity) can access and use healthcare. This study is important to provide the groundwork for further studies to explore the intersectionality of healthcare utilization and socioeconomic status in patients with cognitive impairments.
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