Hospitals serving high concentrations of patients with dementia are associated with lower mortality rates for patients with dementia

Abstract INTRODUCTION While hospital‐related spending is substantially higher for ADRD populations, it is unknown whether differences exist in the use of hospital services in those hospitals serving high proportions of patients with dementia. METHODS We used 2014–2019 Medicare claims to compare hospitals treating high (321 high dementia concentration hospitals [HDCH]) and low (2887 non‐HDCHs) proportions of dementia populations according to finances, utilization, and quality. RESULTS More than one‐quarter of HDCH patients have dementia. HDCHs are small, treat minoritized patient populations, have low‐profit margins and poor overall performance, but are associated with lower 1‐month mortality risk for dementia populations. DISCUSSION Large proportions of patients treated at a subset of small, poorly resourced, and poorly performing US hospitals have dementia. However, unlike at larger, better‐performing hospitals, those treated at HDCHs appear to have lower mortality risk. This may reflect the benefits of specialization or other benefits of treatment at smaller, community hospitals.