Hospitals serving high concentrations of patients with dementia are associated with lower mortality rates for patients with dementia
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".