Very Mild Dementia and Medical Comorbidity Independently Predict Health Care Use in the Elderly
| Autor: | Ellen Grober PhD, Amy Sanders MD, Charles B. Hall PhD, Amy R. Ehrlich MD, Richard B. Lipton MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Journal of Primary Care & Community Health, Vol 3 (2012) |
| Druh dokumentu: | article |
| ISSN: | 2150-1319 2150-1327 21501319 |
| DOI: | 10.1177/2150131911412783 |
| Popis: | Objective : To determine whether dementia status and medical burden were independent predictors of emergency department (ED) visits and hospitalizations in older patients from an urban geriatric practice participating in a primary care based cognitive screening program. Participants and Methods : A comprehensive chart review was conducted for 300 African American and Caucasian patients, including 46 with prevalent dementia and 28 with incident dementia using the Cumulative Illness Burden Scale. Hospital-based claims data was used to retrieve ED visits and hospital admissions for 5 years following baseline assessment. Results : Patients with dementia had a 49% higher rate of ED visits (IRR = 1.49; 95% CI = 1.06, 2.09) and an 83% higher risk of death than patients without dementia (HR = 1.83; 95% CI = 3.07, 0.03). Dementia status predicted hospital admissions after adjustment for medical burden (IRR = 1.37; 95% CI = 0.99, 1.89). For each one point increase in medical burden, there was an 11% increase in ED visits (IRR = 1.11; 95% CI = 1.06, 1.16), a 13% increase in hospital admissions (IRR = 1.13; 95% CI = 1.09, 1.17), and an 11% higher risk of death (HR = 1.11; 95% CI = 1.04, 1.17). Age did not predict utilization. Conclusion : Dementia status and medical burden were independent predictors of ED visits and death in patients with clinically diagnosed dementia followed from the early stage of disease. |
| Databáze: | Directory of Open Access Journals |
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