Januszewicz Joseph, Fowler Nicole R, Mackwood Matthew B, Fisher Elliott, Andrews Alice O, Schmidt Rachel O, Akré Ellesse-Roselee L, Schifferdecker Karen E
Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Alzheimers Dement. 2025 Mar;21(3):e70064. doi: 10.1002/alz.70064.
It is unknown how prepared primary care practices are to deliver recommended dementia care.
A nationally representative survey of US primary care practices focused on care delivery processes, including those for patients with Alzheimer's disease and related dementias (ADRD).
A total of 1245 of 3498 practices (36%) responded. Most practices reported systems to detect patients with ADRD (67%) and refer patients for diagnostic testing (75%). Fewer required ADRD-related training (45%-46%) or maintained an ADRD registry (29%). Practices that scored higher on ADRD care preparedness were more likely to be smaller, receive a higher proportion of revenue from Medicare, and have other important practice capabilities.
Primary care practices have mixed preparedness to care for patients with ADRD. Efforts to boost ADRD preparedness, including providing adequate infrastructure and resources directly to primary care, should be a priority to address disparities in diagnosis and to optimize the patient and caregiver journey.
Mixed ADRD preparedness identified in primary care practices across the United States. Practices often lack ADRD-specific registries and staff training initiatives. Medicare-reliant and larger physician-owned groups show higher ADRD preparedness. FQHCs reported lower ADRD preparedness, highlighting potential gaps in care. Cultural awareness and other support services correlate with better ADRD readiness.
初级保健机构在提供推荐的痴呆症护理方面准备得如何尚不清楚。
对美国初级保健机构进行的一项具有全国代表性的调查，重点关注护理提供流程，包括针对阿尔茨海默病及相关痴呆症（ADRD）患者的流程。
3498家机构中有1245家（36%）做出了回应。大多数机构报告有检测ADRD患者的系统（67%）以及将患者转诊进行诊断测试的系统（75%）。要求进行ADRD相关培训的机构较少（45%-46%），维持ADRD登记册的机构也较少（29%）。在ADRD护理准备方面得分较高的机构更可能规模较小，从医疗保险获得的收入比例更高，并且具备其他重要的机构能力。
初级保健机构在护理ADRD患者方面的准备情况参差不齐。加强ADRD准备的努力，包括直接为初级保健提供充足的基础设施和资源，应成为解决诊断差异以及优化患者和护理人员就医过程的优先事项。
在美国各地的初级保健机构中发现了参差不齐的ADRD准备情况。机构往往缺乏ADRD特定的登记册和员工培训计划。依赖医疗保险的机构和较大的医生所有团体显示出更高的ADRD准备程度。联邦合格健康中心（FQHC）报告的ADRD准备程度较低，凸显了护理方面的潜在差距。文化意识和其他支持服务与更好的ADRD准备情况相关。
