| アブストラクト | OBJECTIVES: Healthcare services for people living with dementia (PLWD) are stretched, and government promises of increased funding remain undelivered. With the UK dementia population to surpass 1 million by 2024, and dementia care costs predicted to almost treble by 2040, it is essential we understand differences in healthcare use among PLWD. This study aimed to explore social and spatial variations in healthcare use among people diagnosed with dementia (2002-2016). METHODS: Data were derived from Electronic Health Records of Clinical Practice Research Datalink GP patients in England (n = 142,302). To standardise healthcare contacts, rates of healthcare contacts per year were calculated for three primary (GP observations and medications) and three secondary healthcare types [Accident & Emergency (A&E) attendances and, emergency and elective hospital admissions]. Fully-adjusted generalised linear regression models were used to identify healthcare use variation by social and spatial groups. Twelve models were generated, one for each healthcare type in early- and late-onset populations separately. RESULTS: This study highlights numerous social and spatial variations in healthcare use among PLWD. Among PLWD, several groups tended to have healthcare service use more closely associated with negative outcomes, including a greater likelihood of A&E attendances and emergency and elective hospital admissions. These groups include: men, people from White ethnicity groups and people from more deprived and rural areas. CONCLUSIONS: Systemic and social measures are needed to reduce variations in healthcare use inequalities in PWLD. These include greater healthcare continuity, health checks and medicines reviews, culturally appropriate services, better and more accessible treatment and improved infrastructure. |
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| ジャーナル名 | Aging & mental health |
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| 投稿日 | 2022/8/13 |
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| 投稿者 | Watson, James; Green, Mark A; Giebel, Clarissa; Darlington-Pollock, Frances; Akpan, Asangaedem |
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| 組織名 | School of Environmental Sciences, The University of Liverpool, Liverpool, United;Kingdom.;Department of Primary Care and Mental Health, University of Liverpool, Liverpool,;United Kingdom.;NIHR ARC NWC, Liverpool, United Kingdom.;Department of Sciences, University of York, York, United Kingdom.;Department of Medicine for Older People and Stroke, Liverpool University;Hospitals NHS FT, Liverpool, United Kingdom.;Healthy Ageing Group, University of Cumbria, Cumbria, United Kingdom.;Institute of Life Course and Medical Sciences, University of Liverpool,;Liverpool, United Kingdom.;NIHR CRN NWC, Liverpool, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35959941/ |
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