Integrating traditional Chinese medicine healthcare into dementia care plan by reducing the need for special nursing care and medical expenses

Abstract

Reducing the need for advanced nursing care and medical expenses is an essential concern of dementia care. We investigated the impact of traditional Chinese medicine (TCM) on advanced nursing care and medical costs.We used Longitudinal Health Insurance Database to implement a cohort study of patients with dementia between 1997 and 2012 in Taiwan. Data from the onset of dementia to 1st advanced nursing care for the endotracheal tube, urinal indwelling catheterization, and nasogastric tube were assessed using Cox regression proportional hazards model, and independent t test was used to determine the difference of hospitalization costs and days. We also used ANOVA test to compare the hospital cost, hospital stay, and numbers according to different duration of TCM.We assessed 9438 new diagnosed patients with dementia without advanced nursing care were categorized into 2 groups: 4094 (43.4%) TCM users, and 5344 (56.6%) non-TCM users. In the TCM groups, 894 (21.8%) patients were declared as advanced nursing care, while 1683 (31.5%) patients were in non-TCM group. Cox proportional hazard regression indicated that using TCM may decrease the need for advanced nursing care (adjusted hazard ratio (aHR) = 0.61, 95% confidence interval [95% CI]: 0.56-0.66) compared to non-TCM. The TCM users have lower hospitalization costs and hospitalization time compared to non-TCM users.Integrating TCM healthcare into dementia care was found to be associated with a lower need for advanced nursing care, hospitalization costs, and admission time with more benefits from longer durations of TCM use.

Figure 1

Recruitment flowchart of patients with dementia from NHIRD. We enrolled 9438 patients with dementia, and divided participants into 2 groups: TCM treatment group (4094 patients, 43.4%) and non-TCM treatment group (5344 patients, 56.6%). In the TCM group, 894 (21.8%) patients were declared as advanced nursing care, while 1683 (31.5%) in non-TCM group. NHIRD = National Health Insurance Research Database, TCM = traditional Chinese medicine.

Figure 2

Survival curve of advanced nursing care in patients with dementia. Kaplan–Meier survival curves and log-rank analyses revealed significant differences in the rates of advanced nursing care between TCM and non-TCM users (log-rank test, P < .001). TCM = traditional Chinese medicine.

Figure 3

Independent t test for accumulated hospitalization costs in patients with dementia. The TCM users have lower hospitalization costs compared to non-TCM users. The mean difference was 867.3 USD, and the P-value was .014. TCM = traditional Chinese medicine.

Figure 4

Independent t test for accumulated number of days in hospital for patients with dementia. The TCM users have lower hospitalization days compared to non-TCM users. The mean difference was 5.19 days, and the P-value was .035. TCM = traditional Chinese medicine.