Acute Healthcare Utilization of a Multidisciplinary Neurocognitive Dementia Patient Cohort
| Autor: | Timothy Thoits, Nicholas J. Andersen, Janani Sadasivan, Jessica Parker |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Referral dementia care business.industry Medical record Neuropsychology healthcare utilization neurocognitive clinics medicine.disease 03 medical and health sciences 0302 clinical medicine Neurology Multidisciplinary approach Health care Cohort Emergency medicine medicine Dementia Original Article 030212 general & internal medicine Neurology (clinical) business Neurocognitive 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neurology (Seoul, Korea) |
| ISSN: | 1738-6586 |
| Popis: | Background and purpose Upon referral from the primary care provider (PCP), dementia is diagnosed either by a neuropsychological evaluation (NPE) or at a multidisciplinary neurocognitive clinic (MNC). Following the NPE, patients continue receiving care from their PCP. In contrast, patients at the MNC are followed by a multidisciplinary care team that provides expertise across specialties in dementia care and education for the patient, family members, and care providers. The purpose of the study was to determine the utilization of acute healthcare services during the 2 years following a diagnosis of dementia in patients from the MNC and NPE. Methods A retrospective review was performed of 581 electronic medical records from January 2010 through December 2014 for 2 cohorts of patients diagnosed with dementia 1) by a neuropsychologist or 2) in a MNC. Acute-care hospital admissions, emergency room (ER) visits, and nonroutine PCP visits were identified. Categorical demographics and utilization variables were summarized by frequency. Chi-square analysis was used to analyze demographic characteristics and overall utilization between MNCs and NPE. Utilization in comparison with various demographic characteristics was analyzed using Spearman correlation coefficients and negative binomial regressions. Results Patients evaluated in the MNC were older, more severely impaired, and lived alone more often compared with NPE patients, but there was no increase in hospital admissions and ER visits. Patients who underwent NPE were 1.58 times more likely to have a nonroutine PCP office visit than patients evaluated in the MNC (p=0.0093). Conclusions Performing follow-up in multidisciplinary clinics provides patients with more education and may help to reduce the utilization of healthcare services. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|