德国痴呆症诊断前后门诊医疗保健的利用模式——一项病例对照研究的结果。
Utilization patterns of ambulatory medical care before and after the diagnosis of dementia in Germany--results of a case-control study.
机构信息
Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Dement Geriatr Cogn Disord. 2010;29(6):475-83. doi: 10.1159/000310350. Epub 2010 Jun 3.
AIMS
To analyze how the diagnosis of dementia changes the utilization of the ambulatory medical care services in the German statutory health insurance.
METHODS
In this case-control study, claims data of 1,848 insurants aged >or=65 years with incident dementia and 7,392 matched controls were compared regarding their utilization of ambulatory medical care services.
RESULTS
We found an increase in the utilization of ambulatory medical care services by demented patients of 50% in the year before and of 40% in the year after the incidence, predominantly in primary care and neurology/psychiatry settings. A negative interaction effect of age and gender (p <or= 0.000) was found regarding the number of visited physicians.
CONCLUSION
Service utilization by demented patients increases already within the year before the first diagnosis and stays on a relatively high level within the year after. Especially (female) patients aged 80 years and older at dementia onset ought to be observed to prevent a possible undersupply.
目的
分析痴呆症的诊断如何改变德国法定健康保险中门诊医疗服务的利用情况。
方法
在这项病例对照研究中，对 1848 名年龄≥65 岁的新发痴呆症患者和 7392 名匹配对照者的理赔数据进行了比较，以评估他们对门诊医疗服务的利用情况。
结果
我们发现，痴呆症患者在发病前一年和发病后一年的门诊医疗服务利用率分别增加了 50%和 40%，主要集中在初级保健和神经科/精神病科。年龄和性别之间存在负交互效应（p<0.000），表现为就诊医生数量的差异。
结论
痴呆症患者的服务利用率在首次诊断前一年内就已经增加，并在诊断后一年内保持在相对较高的水平。特别是在痴呆症发病时年龄≥80 岁的（女性）患者，应该进行观察，以防止可能的供应不足。
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