Race-Specific Impact of Telehealth Advance Care Planning on Cost of Dementia: A Cost Prediction Study

Peter S. Reed (), Yonsu Kim, Jay J. Shen, Sai Kosaraju, Mingon Kang, Jennifer Carson, Iulia Ioanitoaia Chaudhry, Sarah Kim, Connor Jeong, Yena Hwang and Ji Won Yoo
Additional contact information
Peter S. Reed: Sanford Center for Aging, School of Medicine, University of Nevada, Reno, Reno, NV 89557, USA
Yonsu Kim: Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
Jay J. Shen: Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA
Sai Kosaraju: Department of Computer Science, California State Polytechnic University, Pomona, CA 91768, USA
Mingon Kang: Department of Computer Science, Howard Hughes College of Engineering, University of Nevada, Las Vegas, NV 89154, USA
Jennifer Carson: Department of Health Behavior, Policy and Administration Sciences, School of Public Health, University of Nevada, Reno, Reno, NV 89557, USA
Iulia Ioanitoaia Chaudhry: Veterans Affairs Southern Nevada Healthcare System, North Las Vegas, NV 89086, USA
Sarah Kim: The Connection Sphere, Las Vegas, NV 89144, USA
Connor Jeong: Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA
Yena Hwang: The Connection Sphere, Las Vegas, NV 89144, USA
Ji Won Yoo: Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89154, USA

IJERPH, 2025, vol. 22, issue 9, 1-11

Abstract: Identifying strategies to enhance patient engagement and to control healthcare costs promotes a responsive and efficient healthcare system. The aim of this study is to predict healthcare cost savings associated with delivering telehealth advance care planning (ACP) to patients living with dementia. Two Geriatrics Workforce Enhancement Programs delivered training to primary care providers on using telehealth to provide ACP. Using electronic health records data from 6344 dual-eligible Medicare/Medicaid patients receiving telehealth primary care from trained providers in an urban safety net system, persons living with dementia ( n = 401) were identified by extracting ICD-10 codes. The primary outcome was the estimated hospitalization-associated cost, with a key independent variable of ACP billing status. Multiple linear regressions and machine learning techniques estimated the impact of telehealth ACP on hospitalization-associated costs with a differential analysis by race. Compared to non-Hispanic Whites, hospitalization costs among Hispanic elders were higher by USD 14,232.40. Costs for non-English speakers or those having increased comorbidities were higher by USD 27,346.60 and USD 26,072.70, respectively. Overall, receiving ACP was associated with lower costs of USD 23,928.84. Dementia patients seen by primary care providers in a system receiving training to offer ACP via telehealth realized significant cost savings, with marked differences among those of non-White racial backgrounds.

Keywords: cost; health disparity; dementia; advance care planning; workforce education (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/9/1399/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/9/1399/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:9:p:1399-:d:1744148

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().