| アブストラクト | BACKGROUND: Reducing hospital admissions among people dying with dementia is a policy priority. AIM: To explore associations between primary care contacts, continuity of primary care, identification of palliative care needs, and unplanned hospital admissions among people dying with dementia. DESIGN AND SETTING: This was a retrospective cohort study using the Clinical Practice Research Datalink linked with hospital records and Office for National Statistics data. Adults (>18 years) who died between 2009 and 2018 with a diagnosis of dementia were included in the study. METHOD: The association between GP contacts, Herfindahl-Hirschman Index continuity of care score, palliative care needs identification before the last 90 days of life, and multiple unplanned hospital admissions in the last 90 days was evaluated using random-effects Poisson regression. RESULTS: In total, 33 714 decedents with dementia were identified: 64.1% (n = 21 623) female, mean age 86.6 years (SD 8.1), mean comorbidities 2.2 (SD 1.6). Of these, 1894 (5.6%) had multiple hospital admissions in the last 90 days of life (increase from 4.9%, 95% confidence interval [CI] = 4.2 to 5.6 in 2009 to 7.1%, 95% CI = 5.7 to 8.4 in 2018). Participants with more GP contacts had higher risk of multiple hospital admissions (incidence risk ratio [IRR] 1.08, 95% CI = 1.05 to 1.11). Higher continuity of care scores (IRR 0.79, 95% CI = 0.68 to 0.92) and identification of palliative care needs (IRR 0.66, 95% CI = 0.56 to 0.78) were associated with lower frequency of these admissions. CONCLUSION: Multiple hospital admissions among people dying with dementia are increasing. Higher continuity of care and identification of palliative care needs are associated with a lower risk of multiple hospital admissions in this population, and might help prevent these admissions at the end of life. |
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| ジャーナル名 | The British journal of general practice : the journal of the Royal College of General Practitioners |
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| Pubmed追加日 | 2022/7/12 |
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| 投稿者 | Leniz, Javiera; Gulliford, Martin; Higginson, Irene J; Bajwah, Sabrina; Yi, Deokhee; Gao, Wei; Sleeman, Katherine E |
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| 組織名 | NIHR clinician scientist and honorary consultant in palliative medicine, Cicely;Saunders Institute for Palliative Care, Policy & Rehabilitation, Florence;Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College;London, London.;Department of Population Health Sciences, Faculty of Life Science & Medicine,;King's College London, London. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35817583/ |
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