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Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada

BACKGROUND: Patients with dementia have increased healthcare utilization and often have comorbid chronic conditions. It is not clear if the increase in utilization is driven by dementia, the comorbidities or both. The objective of this study was to describe the number and types of comorbid condition...

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Autores principales: Griffith, Lauren E., Gruneir, Andrea, Fisher, Kathryn, Panjwani, Dilzayn, Gandhi, Sima, Sheng, Li, Gafni, Amiram, Patterson, Christopher, Markle-Reid, Maureen, Ploeg, Jenny
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080690/
https://www.ncbi.nlm.nih.gov/pubmed/27784289
http://dx.doi.org/10.1186/s12877-016-0351-x
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author Griffith, Lauren E.
Gruneir, Andrea
Fisher, Kathryn
Panjwani, Dilzayn
Gandhi, Sima
Sheng, Li
Gafni, Amiram
Patterson, Christopher
Markle-Reid, Maureen
Ploeg, Jenny
author_facet Griffith, Lauren E.
Gruneir, Andrea
Fisher, Kathryn
Panjwani, Dilzayn
Gandhi, Sima
Sheng, Li
Gafni, Amiram
Patterson, Christopher
Markle-Reid, Maureen
Ploeg, Jenny
author_sort Griffith, Lauren E.
collection PubMed
description BACKGROUND: Patients with dementia have increased healthcare utilization and often have comorbid chronic conditions. It is not clear if the increase in utilization is driven by dementia, the comorbidities or both. The objective of this study was to describe the number and types of comorbid conditions in a population-based cohort of older adults with dementia and how the level of comorbidity impacts dementia-related and non-dementia-related health service utilization. METHODS: This study is a retrospective cohort study using multiple linked administrative databases to examine health service utilization and costs of 100,630 community-living older adults living with pre-existing dementia in Ontario, Canada. Comorbid conditions and health service utilization were measured using administrative data (physician visits, emergency department visits, hospitalizations, and homecare contacts). RESULTS: Nearly all, 96.3 %, had at least one comorbid condition, while 18.4 % had five or more comorbid conditions. The most common comorbid conditions were hypertension (77.8 %), and arthritis (66.2 %). All types of utilization increased consistently with the number of comorbid conditions. The average number of dementia-related services tended to be similar across all levels of comorbidity while the average number of non-dementia related visits tended to increase with the level of comorbidity. CONCLUSIONS: Comorbidities in community-living older adults with dementia are common and account for a substantial proportion of health service use and costs in this population. Our results suggest that comprehensive programs that take a holistic view to identify the needs of patients in the context of other comorbidities are required for persons with dementia living in the community. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0351-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-50806902016-10-31 Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada Griffith, Lauren E. Gruneir, Andrea Fisher, Kathryn Panjwani, Dilzayn Gandhi, Sima Sheng, Li Gafni, Amiram Patterson, Christopher Markle-Reid, Maureen Ploeg, Jenny BMC Geriatr Research Article BACKGROUND: Patients with dementia have increased healthcare utilization and often have comorbid chronic conditions. It is not clear if the increase in utilization is driven by dementia, the comorbidities or both. The objective of this study was to describe the number and types of comorbid conditions in a population-based cohort of older adults with dementia and how the level of comorbidity impacts dementia-related and non-dementia-related health service utilization. METHODS: This study is a retrospective cohort study using multiple linked administrative databases to examine health service utilization and costs of 100,630 community-living older adults living with pre-existing dementia in Ontario, Canada. Comorbid conditions and health service utilization were measured using administrative data (physician visits, emergency department visits, hospitalizations, and homecare contacts). RESULTS: Nearly all, 96.3 %, had at least one comorbid condition, while 18.4 % had five or more comorbid conditions. The most common comorbid conditions were hypertension (77.8 %), and arthritis (66.2 %). All types of utilization increased consistently with the number of comorbid conditions. The average number of dementia-related services tended to be similar across all levels of comorbidity while the average number of non-dementia related visits tended to increase with the level of comorbidity. CONCLUSIONS: Comorbidities in community-living older adults with dementia are common and account for a substantial proportion of health service use and costs in this population. Our results suggest that comprehensive programs that take a holistic view to identify the needs of patients in the context of other comorbidities are required for persons with dementia living in the community. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0351-x) contains supplementary material, which is available to authorized users. BioMed Central 2016-10-26 /pmc/articles/PMC5080690/ /pubmed/27784289 http://dx.doi.org/10.1186/s12877-016-0351-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Griffith, Lauren E.
Gruneir, Andrea
Fisher, Kathryn
Panjwani, Dilzayn
Gandhi, Sima
Sheng, Li
Gafni, Amiram
Patterson, Christopher
Markle-Reid, Maureen
Ploeg, Jenny
Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title_full Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title_fullStr Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title_full_unstemmed Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title_short Patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in Ontario, Canada
title_sort patterns of health service use in community living older adults with dementia and comorbid conditions: a population-based retrospective cohort study in ontario, canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080690/
https://www.ncbi.nlm.nih.gov/pubmed/27784289
http://dx.doi.org/10.1186/s12877-016-0351-x
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