Schwarzkopf Larissa, Hao Yi, Holle Rolf, Graessel Elmar
Helmholtz Zentrum München, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Department of Medical Psychology and Medical Sociology, Alexander-Universität Erlangen-Nürnberg, Clinic for Psychiatry and Psychotherapy, Erlangen, Germany.
Dement Geriatr Cogn Dis Extra. 2014 Jun 28;4(2):195-208. doi: 10.1159/000362806. eCollection 2014 May.
Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse.
We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization.
In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy) remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles.
Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care.
在横断面研究中对基于社区和机构的痴呆症护理进行了比较，但关于机构化对医疗服务利用影响的纵向信息很少。
我们通过广义估计方程分析了651名痴呆症患者的理赔数据，以评估机构化前四个季度到机构化后四个季度的医疗服务利用情况和相应支出。
在所有领域，机构化当季的利用率均有所提高。此后，药物、医疗辅助器具和非医师服务（如职业治疗和物理治疗）的使用仍居高不下，但住院和门诊治疗的使用减少。护理成本呈现相应的情况。
机构痴呆症护理似乎与对支持性服务的需求增加有关，但不一定与专科医疗护理需求增加有关。
