Liu Jodi L, Baker Lawrence, Chen Annie Yu-An, Wang Jue Jessie
RAND, Economics, Sociology, and Statistics Department, Santa Monica, CA 90407-2138, USA.
RAND, Pardee RAND Graduate School, Santa Monica, CA 90407-2138, USA.
Health Aff Sch. 2024 Jul 18;2(7):qxae088. doi: 10.1093/haschl/qxae088. eCollection 2024 Jul.
Dementia specialists-neurologists, geriatricians, and geriatric psychiatrists-serve a critical clinical function in diagnosing early-stage Alzheimer's disease and determining eligibility for treatment with disease-modifying therapies. However, the availability of dementia specialists is limited and varies across the United States. Using data from the Area Health Resources Files, we found that the median density of dementia specialists across hospital referral regions in United States is 28.8 per 100 000 population aged 65 years and older (interquartile range 19.3-43.6). We derived thresholds of 33-45 dementia specialists per 100 000 population aged 65 years and older as the provider density necessary to care for older adults with mild cognitive impairment and dementia. Based on these thresholds, we estimated that 34%-59% of the population aged 65 years and older resided in areas with potential dementia specialist shortfalls. The extent of potential shortfalls varied by state and rurality. A better understanding of potential gaps in the availability of dementia specialists will inform policies and practices to ensure access to services for people with cognitive impairment and dementia.
痴呆症专科医生（神经科医生、老年病科医生和老年精神科医生）在诊断早期阿尔茨海默病以及确定使用疾病修正疗法进行治疗的资格方面发挥着关键的临床作用。然而，痴呆症专科医生的数量有限，且在美国各地存在差异。利用地区卫生资源档案的数据，我们发现美国各医院转诊地区痴呆症专科医生的中位数密度为每10万65岁及以上人口中有28.8名（四分位距为19.3 - 43.6）。我们得出每10万65岁及以上人口中有33 - 45名痴呆症专科医生的阈值，作为照顾轻度认知障碍和痴呆症老年人所需的医疗服务提供者密度。基于这些阈值，我们估计65岁及以上人口中有34% - 59%居住在痴呆症专科医生可能短缺的地区。潜在短缺的程度因州和农村地区而异。更好地了解痴呆症专科医生可及性方面的潜在差距，将为政策和实践提供信息，以确保认知障碍和痴呆症患者能够获得服务。
