Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada

BMC Geriatrics

Research Article

Amiram Gafni¹  Lauren E. Griffith²  Andrea Gruneir³  Christopher Patterson⁴  Li Sheng⁵  Sima Gandhi⁵  Kathryn Fisher⁶  Maureen Markle-Reid⁶  Jenny Ploeg⁶  Dilzayn Panjwani⁷ 

[1] Centre for Health Economics and Policy Analysis; Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Room CRL-208, L8S 4K1, Hamilton, ON, Canada;Department of Clinical Epidemiology and Biostatistics, McMaster University, McMaster Innovation Park, 175 Longwood Road South, L8P 0A1, Hamilton, ON, Canada;Department of Family Medicine, 6-40 University of Alberta, 6-10 University Terrace, T6G 2T4, Edmonton, AB, Canada;Department of Medicine, McMaster University, Health Sciences Centre, 1280 Main Street West, Room 3N25B, L8S 4K1, Hamilton, ON, Canada;Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada;School of Nursing, McMaster University, Health Sciences Centre, 1280 Main Street West, Room 3N25B, L8S 4K1, Hamilton, ON, Canada;Women’s College Research Institute, Women’s College Hospital, 790 Bay St., 7th floor, M5G 1N8, Toronto, ON, Canada;

关键词: Dementia;    Community-living older adults;    Health service utilization;    Health service costs;    Comorbidity;   

DOI  :  10.1186/s12877-016-0351-x

 received in 2016-06-21, accepted in 2016-10-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPatients with dementia have increased healthcare utilization and often have comorbid chronic conditions. It is not clear if the increase in utilization is driven by dementia, the comorbidities or both. The objective of this study was to describe the number and types of comorbid conditions in a population-based cohort of older adults with dementia and how the level of comorbidity impacts dementia-related and non-dementia-related health service utilization.MethodsThis study is a retrospective cohort study using multiple linked administrative databases to examine health service utilization and costs of 100,630 community-living older adults living with pre-existing dementia in Ontario, Canada. Comorbid conditions and health service utilization were measured using administrative data (physician visits, emergency department visits, hospitalizations, and homecare contacts).ResultsNearly all, 96.3 %, had at least one comorbid condition, while 18.4 % had five or more comorbid conditions. The most common comorbid conditions were hypertension (77.8 %), and arthritis (66.2 %). All types of utilization increased consistently with the number of comorbid conditions. The average number of dementia-related services tended to be similar across all levels of comorbidity while the average number of non-dementia related visits tended to increase with the level of comorbidity.ConclusionsComorbidities in community-living older adults with dementia are common and account for a substantial proportion of health service use and costs in this population. Our results suggest that comprehensive programs that take a holistic view to identify the needs of patients in the context of other comorbidities are required for persons with dementia living in the community.

【 授权许可】

CC BY   
© The Author(s). 2016