关键词: Dementia care Elderly Health service utilization Inequality Population-level Variation

Mesh : Age Distribution Aged Aged, 80 and over Antidepressive Agents / standards therapeutic use Antipsychotic Agents / standards therapeutic use Canada / epidemiology Cohort Studies Community Health Planning Delivery of Health Care / methods standards Dementia / diagnosis epidemiology therapy Disease Management Female Healthcare Disparities Humans Male Neuroimaging Physical Examination

来  源:   DOI:10.1016/j.jalz.2015.02.008   PDF(Sci-hub)

Abstract:
BACKGROUND: Evidence indicates that early detection and management of dementia care can improve outcomes. We assess variations in dementia care based on processes outlined in clinical guidelines by the BC Ministry of Health.
METHODS: A population-based retrospective cohort study of community-dwelling seniors using patient-level administrative data in British Columbia, Canada. Guidelines measured: laboratory testing, imaging, prescriptions, complete examination, counseling, and specialist referral.
RESULTS: Older patients were less likely to receive guideline-consistent medical care. Patients in higher income categories had higher odds of receiving counseling (confidence interval or CI 1.13-153) and referrals (15.1 CI 1.18-1.95) compared with those of lower income. Over a quarter of the cohort received an antipsychotic (28%) or nonrecommended benzodiazepine (26%). Individuals living within \"rural\" health authorities or of low income were more likely to receive antipsychotic treatment.
CONCLUSIONS: Patterns of inequality by age and income may signal barriers to care, particularly for management of dementia care processes.
摘要:
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