{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:46:10Z","timestamp":1789393570060,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["K12TR004522"],"award-info":[{"award-number":["K12TR004522"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015620","name":"Center for Innovations in Quality, Effectiveness and Safety","doi-asserted-by":"publisher","award":["CIN 13\u2010413"],"award-info":[{"award-number":["CIN 13\u2010413"]}],"id":[{"id":"10.13039\/100015620","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["2P01AG027296\u201011"],"award-info":[{"award-number":["2P01AG027296\u201011"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with dementia have high rates of emergency department (ED) and hospital utilization, high mortality and costs, and other poor outcomes. To successfully impact the care trajectories of these patients, health care systems must pragmatically identify the correct target population. This study described patterns of ED utilization by people with dementia and explored the accuracy of administrative data models to predict mortality and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of a 20% random sample of Traditional Medicare (TM) beneficiaries with dementia, age \u2265\u200966\u2009years, and an index ED visit in 2018. One\u2010year mortality and high costs were described, and associations with the timing of prior hospitalizations examined. As a preliminary step to evaluate models based on administrative data only, C\u2010statistics were used to examine the accuracy of eight multivariate models, stratified by the setting of care before and after an ED visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of the 250,343 person cohort of individuals with dementia resided in the community before their index ED encounter (83.9%) rather than in a nursing home (NH, 16.1%), and 34.4% required hospitalization. One\u2010year mortality by location varied from 18.4% (community before and after ED visit) to 47% (admitted NH residents). One\u2010year mortality was 40.3% for those hospitalized within the past month, and 26.2% for those hospitalized 6+ months before the ED encounter. C\u2010statistics were less than or equal to 0.72 for seven multivariate models, and 0.81 for the model examining high costs for NH residents discharged back to their NH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mortality and costs for people with dementia vary by location of care before and after ED encounters, as well as by timing of prior hospitalizations. However, multivariate models using only administrative data lack accuracy, suggesting the need to add pragmatically selected clinical data and\/or other measures to better identify the \u201cright patients, at the right time\u201d.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70260","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:39:32Z","timestamp":1766489972000},"page":"822-828","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting Mortality and Costs After Emergency Department Visits by People With Dementia: Timing and Location Matter"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0254-2332","authenticated-orcid":false,"given":"Jason K.","family":"Bowman","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"Division of Geriatrics and Palliative Care, Department of Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"Center for Innovations in Quality Effectiveness and Safety, Michael E. DeBakey VA Medical Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine S.","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Department of Medicine  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Ouchi","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital Department of Emergency Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyler M.","family":"Godwin","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality Effectiveness and Safety, Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Tulsky","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Dana Farber Cancer Institute Department of Supportive Oncology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan M.","family":"Teno","sequence":"additional","affiliation":[{"name":"Brown University School of Public Health  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.19025"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALZ.13809"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JAMDA.2022.05.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/JPM.2018.0359"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.37765\/AJMC.2024.89542"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001270"},{"key":"e_1_2_9_8_1","volume-title":"Guiding an Improved Dementia Experience (GUIDE) Model","author":"CMS","year":"2023"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1377\/HLTHAFF.2022.00185"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAHEALTHFORUM.2024.4802"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/DAD2.12472"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.23889\/IJPDS.V9I1.2407"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1475\u20106773.2004.00315.X"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.18262"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2024.14213"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/INFORMATICS7030025"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000754"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ACEM.12569"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1475\u20106773.2011.01277.X"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1475\u20106773.2010.01194.X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2013.7103"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/JGS.17517"},{"key":"e_1_2_9_23_1","volume-title":"BASE FFS Claims Files","author":"NCI","year":"2024"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/OFID\/OFW010"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007230"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMASURG.2022.5155"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/FNEUR.2021.642426"},{"key":"e_1_2_9_29_1","volume-title":"Emergency Department Visits by Adults Age 65 and Older With Alzheimer Disease: United States, 2020\u20132022","author":"Santo L.","year":"2024"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1377\/HLTHAFF.2020.00670"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1532\u20105415.1999.TB05204.X"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1197\/AEMJ.10.3.224"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2011.1515"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12916\u2010023\u201003048\u20106"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JPAINSYMMAN.2010.02.014"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2010.1572"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/S12877\u2010024\u201005389\u20100"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.37765\/AJMC.2022.88818"},{"issue":"3","key":"e_1_2_9_39_1","first-page":"21","article-title":"Risk Stratification: A Two\u2010Step Process for Identifying Your Sickest Patients","volume":"26","author":"Dera J. 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