The Comparative Health Outcomes, Policy and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.
Stanford Center on Longevity, Stanford University, Stanford, CA, USA.
J Alzheimers Dis. 2023;96(2):801-811. doi: 10.3233/JAD-230505.
Despite the high burden of Alzheimer's disease and other dementias among the Hispanic population worldwide, little is known about how dementia affects healthcare utilizations among this population outside of the US, in particular among those in the Caribbean region.
This study examines healthcare utilization associated with Alzheimer's disease and other dementias among older adults in the Caribbean as compared to the US.
We conducted harmonized analyses of two population-based surveys, the 10/66 Dementia Group Research data collected in Dominican Republic, Cuba, and Puerto Rico, and the US-based Health and Retirement Study. We examined changes in hospital nights and physician visits in response to incident and ongoing dementias.
Incident dementia significantly increased the risk of hospitalization and number of hospital nights in both populations. Ongoing dementia increased the risk of hospitalization and hospital nights in the US, with imprecise estimates for the Caribbean. The number of physician visits was elevated in the US but not in the Caribbean.
The concentration of increased healthcare utilization on hospital care and among patients with incident dementia suggests an opportunity for improved outpatient management of new and existing dementia patients in the Caribbean.
尽管阿尔茨海默病和其他类型痴呆症在全球范围内给 Hispanic 人群带来了沉重负担，但对于除美国以外的其他国家（尤其是加勒比地区）的 Hispanic 人群中痴呆症对医疗保健利用的影响，我们知之甚少。
本研究旨在比较加勒比地区和美国老年人群中与阿尔茨海默病和其他类型痴呆症相关的医疗保健利用情况。
我们对两项基于人群的调查进行了协调分析，这两项调查分别是在多米尼加共和国、古巴和波多黎各开展的 10/66 痴呆症研究组研究数据，以及美国开展的健康与退休研究。我们分析了痴呆症新发病例和持续病例对住院夜数和就诊医生次数的影响。
痴呆症新发病例显著增加了两个地区的住院风险和住院夜数。持续痴呆症增加了美国的住院风险和住院夜数，但加勒比地区的估计值不够精确。就诊医生的次数在美国有所增加，但在加勒比地区没有增加。
加勒比地区的医疗保健利用率增加主要集中在住院治疗和新发病例痴呆症患者上，这表明有机会改善加勒比地区新发病例和现有痴呆症患者的门诊管理。
