痴呆症患者的医疗保健使用情况:一项基于人群的队列研究。

Profiles of healthcare use of persons living with dementia: A population-based cohort study.

作者信息

Dufour Isabelle, Margo-Dermer Eva, Hudon Catherine, Sirois Caroline, Godard-Sebillotte Claire, Sourial Nadia, Rochette Louis, Quesnel-Vallée Amélie, Vedel Isabelle

机构信息

School of Nursing, Faculty of medicine and health sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada.

Research Center of Aging, Université de Sherbrooke, Sherbrooke, Quebec, Canada.

出版信息

Geriatr Gerontol Int. 2024 Aug;24(8):789-796. doi: 10.1111/ggi.14930. Epub 2024 Jul 5.

Abstract

AIM

Persons living with dementia are a heterogeneous population with complex needs whose healthcare use varies widely. This study aimed to identify the healthcare use profiles in a cohort of persons with incident dementia, and to describe their characteristics.

METHODS

This is a retrospective cohort study of health administrative data in Quebec (Canada). The study population included persons who: (i) had an incident dementia diagnosis between 1 April 2015 and 31 March 2016; (ii) were aged ≥65 years and living in the community at the time of diagnosis. We carried out a latent class analysis to identify subgroups of healthcare users. The final number of groups was chosen based on clinical interpretation and statistical indicators.

RESULTS

The study cohort consisted of 15 584 individuals with incident dementia. Four profiles of healthcare users were identified: (i) Low Users (36.4%), composed of individuals with minimal healthcare use and fewer comorbidities; (ii) Ambulatory Care-Centric Users (27.5%), mainly composed of men with the highest probability of visiting cognition specialists; (iii) High Acute Hospital Users (23.6%), comprised of individuals mainly diagnosed during hospitalization, with higher comorbidities and mortality rate; and (iv) Long-Term Care Destined Users (12.5%), who showed the highest proportion of antipsychotics prescriptions and delayed hospitalization discharge.

CONCLUSIONS

We identified four distinct subgroups of healthcare users within a population of persons living with dementia, providing a valuable context for the development of interventions tailored to specific needs within this diverse population. Geriatr Gerontol Int 2024; 24: 789-796.

摘要

目的

痴呆症患者是一个需求复杂的异质性群体,其医疗保健使用情况差异很大。本研究旨在确定一组新发痴呆症患者的医疗保健使用概况,并描述其特征。

方法

这是一项对加拿大魁北克省卫生行政数据的回顾性队列研究。研究人群包括:(i)在2015年4月1日至2016年3月31日期间被诊断为新发痴呆症的人;(ii)诊断时年龄≥65岁且居住在社区的人。我们进行了潜在类别分析以确定医疗保健使用者的亚组。根据临床解释和统计指标选择最终的组数。

结果

研究队列包括15584名新发痴呆症患者。确定了四种医疗保健使用者概况:(i)低使用者(36.4%),由医疗保健使用最少且合并症较少的个体组成;(ii)以门诊护理为中心的使用者(27.5%),主要由最有可能就诊认知专家的男性组成;(iii)急性医院高使用者(23.6%),由主要在住院期间被诊断出的个体组成,合并症和死亡率较高;以及(iv)注定进入长期护理的使用者(12.5%),他们的抗精神病药物处方比例最高且住院出院延迟。

结论

我们在痴呆症患者群体中确定了四个不同的医疗保健使用者亚组,为针对这一多样化群体的特定需求制定干预措施提供了有价值的背景。《老年医学与老年病学国际杂志》2024年;24:789 - 796。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a8/11503596/821894e58770/GGI-24-789-g002.jpg

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