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. 2021 May 26;18(11):5705.
doi: 10.3390/ijerph18115705.

Healthcare Utilization in Different Stages among Patients with Dementia: A Nationwide Population-Based Study

Yu-Han Chen  1 , Yi-Chen Lai  2 , Yu-Cih Wu  3 , Jun Sasaki  4 , Kang-Ting Tsai  5   6 , Chung-Han Ho  3
Affiliations

Healthcare Utilization in Different Stages among Patients with Dementia: A Nationwide Population-Based Study

Yu-Han Chen et al. Int J Environ Res Public Health. .

Abstract

To evaluate the trend of healthcare utilization among patients with dementia (PwD) in different post-diagnosis periods, Taiwan's nationwide population database was used in this study. PwD were identified on the basis of dementia diagnoses during 2002-2011. We further subdivided the cases into 10 groups from the index year to the 10th year after diagnosis. The frequency of emergency department visits and hospitalizations, the length of stay, outpatient and department visits, and the number of medications used were retrieved. The Joinpoint regression approach was used to estimate the annual percent change (APC) of healthcare utilization. The overall trend of healthcare utilization increased with the progression of dementia, with a significant APC during the first to second year after diagnosis (p < 0.01), except that the frequency of outpatient visits showed a decreasing trend with a significant APC from the first to fifth year. All sex- and age-stratified analyses revealed that male gender and old age contributed to greater use of healthcare services but did not change the overall trend. This study provides a better understanding of medical resource utilization across the full spectrum of dementia, which can allow policymakers, physicians, and caregivers to devise better care plans for PwD.

Keywords: dementia; healthcare utilization; medical services; national health insurance.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure A1
Figure A1
Age-stratified frequency of ED visits during the course of dementia.
Figure A2
Figure A2
Age-stratified frequency of hospitalization during the course of dementia.
Figure A3
Figure A3
Age-stratified mean length of stay during the course of dementia.
Figure A4
Figure A4
Age-stratified frequency of outpatient visits during the course of dementia.
Figure A5
Figure A5
Age-stratified mean number of departments visited during the course of dementia.
Figure A6
Figure A6
Age-stratified mean number of medications for patients.
Figure 1
Figure 1
Flowchart of study subject selection.
Figure 2
Figure 2
Overall and sex-stratified frequency of ED visits during the course of dementia.
Figure 3
Figure 3
Overall and sex-stratified frequency of hospitalization during the course of dementia.
Figure 4
Figure 4
Overall and sex-stratified mean length of stay during the course of dementia.
Figure 5
Figure 5
Overall and sex-stratified frequency of outpatient visits during the course of dementia.
Figure 6
Figure 6
Overall and sex-stratified mean number of departments visited during the course of dementia.
Figure 7
Figure 7
Overall and sex-stratified mean number of medications per patient.
See this image and copyright information in PMC

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