Health services utilization associated with cognitive impairment and dementia in older patients undergoing post-acute rehabilitation.

Détails

ID Serval
serval:BIB_1E8C39AE8C92
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Health services utilization associated with cognitive impairment and dementia in older patients undergoing post-acute rehabilitation.
Périodique
Journal of the American Medical Directors Association
Auteur(s)
Seematter-Bagnoud L., Martin E., Büla C.J.
ISSN
1538-9375 (Electronic)
ISSN-L
1525-8610
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
13
Numéro
8
Pages
692-697
Langue
anglais
Notes
Publication types: Journal Article
Résumé
OBJECTIVE: To investigate the relationship between levels of cognitive impairment and health services utilization in older patients undergoing post-acute rehabilitation.
DESIGN: Cross-sectional study.
SETTING: Post-acute rehabilitation facility.
PARTICIPANTS: Patients (N = 1764) aged 70 years and older admitted over 3 years.
MEASUREMENTS: Sociodemographic, medical, and functional data were collected upon admission. Based on discharge diagnoses, patients were classified as cognitively intact, cognitively impaired with no dementia (CIND), and demented.
RESULTS: Dementia and CIND were diagnosed in 425 (24.1%) and 301 (17.1%) patients, respectively. Gradients from cognitively intact to cognitively impaired to demented patients were observed in median length of stay (19, 22, and 25 days, P < .001), and institutionalization rates at discharge (4.2%, 7.6%, and 28.8%, P < .001). Among patients discharged home, similar gradients were observed in utilization of home care (68.2%, 79.7%, and 83.3%, P < .001) and day care (3.1%, 7.1%, and 14.3%, P < .001). After adjustment, compared with cognitively intact patients, only those with dementia still had longer stays (+2.7 days) and increased odds of institutionalization (adjOR 6.1, 95% CI 4.0-9.3, P < .001). Among patients discharged home, use of home and day care remained higher in those with dementia (adjOR 1.8, 95% CI 1.2-2.7, P = .005, and adjOR 1.8, 95% CI 1.2-2.7, P = .005, respectively), while CIND patients had higher odds of using home care (adjOR 1.6, 95% CI 1.1-2.4, P = .028).
CONCLUSION: Among patients undergoing post-acute rehabilitation, those with dementia had increased use of both institutional and community care, whereas those with CIND had increased use of home care services only. Future studies should investigate specific strategies susceptible to reduce the related burden on health care systems.
Pubmed
Web of science
Création de la notice
08/11/2012 19:24
Dernière modification de la notice
03/03/2018 14:36
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