Evaluating racial disparities in healthcare system utilization and caregiver burden among older adults with dementia.

Autor:	Pereira C; Neurology Department, Ochsner Health, New Orleans, LA, USA., LaRoche A; Neurology Department, Ochsner Health, New Orleans, LA, USA., Arredondo B; Neurology Department, Ochsner Health, New Orleans, LA, USA., Pugh E; Psychology Department, Louisiana State University, Baton Rouge, LA, USA., Disbrow E; Center for Brain Health, LSU Health, Shreveport, LA, USA.; Department of Neurology, LSU Health, Shreveport, LA, USA.; Department of Pharmacology, Toxicology and Neuroscience, Shreveport, LA, USA., Reekes TH; Center for Brain Health, LSU Health, Shreveport, LA, USA.; Department of Pharmacology, Toxicology and Neuroscience, Shreveport, LA, USA., Brickell E; Neurology Department, Ochsner Health, New Orleans, LA, USA., Boettcher A; Neurology Department, Ochsner Health, New Orleans, LA, USA., Sawyer RJ; Neurology Department, Ochsner Health, New Orleans, LA, USA.
Jazyk:	angličtina
Zdroj:	The Clinical neuropsychologist [Clin Neuropsychol] 2022 Feb; Vol. 36 (2), pp. 353-366. Date of Electronic Publication: 2021 Aug 02.
DOI:	10.1080/13854046.2021.1951844
Abstrakt:	Objective: To evaluate racial differences in healthcare utilization and caregiver burden in a culturally diverse population of older adults with dementia. Method: One hundred and thirty-three dyads (person with dementia, PWD and caregiver, CG), with at least one emergency department (ED) visit or hospitalization 12 months prior, were enrolled. Independent sample t -tests and chi-squared analyses were performed to compare racial groups on healthcare utilization and CG burden. Mann-Whitney U test was used for item-level analyses, principal component analysis was used to examine relationships among outcomes, and regressions were used to identify the relationship between race and potential covariates. Results: PWD sample mean age was 79 years, predominantly female, and with high school education. Racial distribution was 65% White and 35% Black. CG sample mean age was 64 years, predominantly female, with more than 12 years of education. No differences were found for age or dementia severity across racial groups. Black PWD experienced more ED and ambulance utilization when compared to White counterparts. Non-emergency hospitalization rates were higher for White PWD. No significant differences were found by race for CG burden total score; however, item-level analysis suggested more anger, reduced social life, uncertainty, and inadequacy in White CGs. Regressions demonstrated a positive relationship between Black race and adult-child CGs with increased ED visits, while dyad educational attainment was associated with hospitalizations independent of race. Conclusions: Healthcare utilization disparities extend to older adults with dementia diagnoses. Our findings suggest that culturally tailored interventions may be appropriate. Future research is encouraged to explore the effect of other covariates.
Databáze:	MEDLINE
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