Abstract
The Department of Health in Puerto Rico has referred to the high prevalence of Alzheimer’s Disease and Related Dementias (ADRD) and higher rates of disability as Public Health Problems on the island.1,2 Persons with disabilities often report substantial unmet needs for home and community-based services.3–7 In addition, patients with ADRD are exposed to catastrophic levels of out-of-pocket spending, with much of this spending on nursing home care.7 Since Medicaid does not cover institutional care in Puerto Rico,8 people with ADRD in Puerto Rico may seek to migrate to the US, where they may be eligible for long-term services and support. This presentation will describe characteristics, health care utilization patterns and migration among older adults in Puerto Rico with ADRD. Using Medicare data including, Medicare claims, the Medicare Provider Analysis and Review, the Minimum Data Set, the Inpatient Rehabilitation Facility Patient Assessment Instrument, and the Outcome and Assessment Information Set, we identified beneficiaries with ADRD in Puerto Rico. There were 694,565 Medicare beneficiaries (18,287 with ADRD) in Puerto Rico. About 66.9% of beneficiaries with ADRD were women, had a mean age of 79.6 years (SD = 9.0) and 48.0% were enrolled in Medicare Advantage for 12 consecutive months. About 350 of those beneficiaries with ADRD migrated to the US mainland the following year. The recent ruling of the US Supreme Court 9 to further allow the exclusion of Puerto Rican residents from disability benefits (decided April 21, 2022) may further exacerbate disparities and migration among vulnerable populations, including among those with ADRD.
Presenters
Maricruz Rivera-HernandezDepartment of Health Services, Policy and Practice, Center for Gerontology and Healthcare Research, Brown University, United States
Details
Presentation Type
Presentation in a Themed Panel
Theme
Community Resilience and Aging
KEYWORDS
Dementia, Health Disparities, Migration
