Cargando…

Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review

BACKGROUND/OBJECTIVES: While it is acknowledged that minority ethnic (ME) groups across international settings face barriers to accessing care for dementia, it is not clear whether ME groups access services less frequently as a result. The objective of this review is to examine whether ME groups hav...

Descripción completa

Detalles Bibliográficos
Autores principales: Co, Melissa, Couch, Elyse, Gao, Qian, Mac‐Ginty, Scarlett, Das‐Munshi, Jayati, Prina, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984264/
https://www.ncbi.nlm.nih.gov/pubmed/33230815
http://dx.doi.org/10.1111/jgs.16929
_version_ 1783668034137751552
author Co, Melissa
Couch, Elyse
Gao, Qian
Mac‐Ginty, Scarlett
Das‐Munshi, Jayati
Prina, Matthew
author_facet Co, Melissa
Couch, Elyse
Gao, Qian
Mac‐Ginty, Scarlett
Das‐Munshi, Jayati
Prina, Matthew
author_sort Co, Melissa
collection PubMed
description BACKGROUND/OBJECTIVES: While it is acknowledged that minority ethnic (ME) groups across international settings face barriers to accessing care for dementia, it is not clear whether ME groups access services less frequently as a result. The objective of this review is to examine whether ME groups have longer delays before accessing dementia/memory services, higher use of acute care and crisis services and lower use of routine care services based on existing literature. We also examined whether ME groups had higher dementia severity or lower cognition when presenting to memory services. DESIGN: Systematic review with narrative synthesis. SETTING: Nonresidential medical, psychiatric, memory, and emergency services. PARTICIPANTS: Twenty studies totaling 94,431 older adults with dementia or mild cognitive impairment. MEASUREMENTS: We searched Embase, Ovid MEDLINE, Global Health, and PsycINFO from inception to November 2018 for peer‐reviewed observational studies which quantified ethnic minority differences in nonresidential health service use in people with dementia. Narrative synthesis was used to analyze findings. RESULTS: Twenty studies were included, mostly from the U.S. (n = 13), as well as the UK (n = 4), Australia (n = 1), Belgium (n = 1), and the Netherlands (n = 1). There was little evidence that ME groups in any country accessed routine care at different rates than comparison groups, although studies may have been underpowered. There was strong evidence that African American/Black groups had higher use of hospital inpatient services versus U.S. comparison groups. Primary care and emergency services were less well studied. Study quality was mixed, and there was a large amount of variability in the way ethnicity and service use outcomes were ascertained and defined. CONCLUSION: There is evidence that some ME groups, such as Black/African American groups in the U.S., may use more acute care services than comparison populations, but less evidence for differences in routine care use. Research is sparse, especially outside the U.S.
format Online
Article
Text
id pubmed-7984264
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher John Wiley & Sons, Inc.
record_format MEDLINE/PubMed
spelling pubmed-79842642021-03-24 Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review Co, Melissa Couch, Elyse Gao, Qian Mac‐Ginty, Scarlett Das‐Munshi, Jayati Prina, Matthew J Am Geriatr Soc Regular Issue Content BACKGROUND/OBJECTIVES: While it is acknowledged that minority ethnic (ME) groups across international settings face barriers to accessing care for dementia, it is not clear whether ME groups access services less frequently as a result. The objective of this review is to examine whether ME groups have longer delays before accessing dementia/memory services, higher use of acute care and crisis services and lower use of routine care services based on existing literature. We also examined whether ME groups had higher dementia severity or lower cognition when presenting to memory services. DESIGN: Systematic review with narrative synthesis. SETTING: Nonresidential medical, psychiatric, memory, and emergency services. PARTICIPANTS: Twenty studies totaling 94,431 older adults with dementia or mild cognitive impairment. MEASUREMENTS: We searched Embase, Ovid MEDLINE, Global Health, and PsycINFO from inception to November 2018 for peer‐reviewed observational studies which quantified ethnic minority differences in nonresidential health service use in people with dementia. Narrative synthesis was used to analyze findings. RESULTS: Twenty studies were included, mostly from the U.S. (n = 13), as well as the UK (n = 4), Australia (n = 1), Belgium (n = 1), and the Netherlands (n = 1). There was little evidence that ME groups in any country accessed routine care at different rates than comparison groups, although studies may have been underpowered. There was strong evidence that African American/Black groups had higher use of hospital inpatient services versus U.S. comparison groups. Primary care and emergency services were less well studied. Study quality was mixed, and there was a large amount of variability in the way ethnicity and service use outcomes were ascertained and defined. CONCLUSION: There is evidence that some ME groups, such as Black/African American groups in the U.S., may use more acute care services than comparison populations, but less evidence for differences in routine care use. Research is sparse, especially outside the U.S. John Wiley & Sons, Inc. 2020-11-24 2021-03 /pmc/articles/PMC7984264/ /pubmed/33230815 http://dx.doi.org/10.1111/jgs.16929 Text en © 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Regular Issue Content
Co, Melissa
Couch, Elyse
Gao, Qian
Mac‐Ginty, Scarlett
Das‐Munshi, Jayati
Prina, Matthew
Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title_full Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title_fullStr Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title_full_unstemmed Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title_short Access to Health Services in Older Minority Ethnic Groups with Dementia: A Systematic Review
title_sort access to health services in older minority ethnic groups with dementia: a systematic review
topic Regular Issue Content
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984264/
https://www.ncbi.nlm.nih.gov/pubmed/33230815
http://dx.doi.org/10.1111/jgs.16929
work_keys_str_mv AT comelissa accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview
AT couchelyse accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview
AT gaoqian accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview
AT macgintyscarlett accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview
AT dasmunshijayati accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview
AT prinamatthew accesstohealthservicesinolderminorityethnicgroupswithdementiaasystematicreview