Sex Differences in Dementia Primary Care Performance and Health Service Use: A Population-Based Study.
Aged
Aged, 80 and over
Cohort Studies
Cross-Sectional Studies
Databases, Factual
Dementia
/ epidemiology
Female
Home Care Services
/ statistics & numerical data
Hospitalization
/ statistics & numerical data
Humans
Male
Ontario
/ epidemiology
Patient Acceptance of Health Care
/ statistics & numerical data
Primary Health Care
/ statistics & numerical data
Sex Factors
dementia
health system performance
indicators
population based
primary care
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
05
08
2019
revised:
10
12
2019
accepted:
31
12
2019
pubmed:
6
2
2020
medline:
20
2
2021
entrez:
6
2
2020
Statut:
ppublish
Résumé
Growing evidence points to underlying sex differences in the risk factors and clinical presentation of dementia. It is unclear, however, whether sex differences also exist in the management and healthcare utilization of persons with dementia. We compared primary care performance and health service use indicators for newly identified men and women with dementia in Ontario, Canada, over a 12-year period. Population-based, repeated cohort study between 2002 and 2014. Ontario, Canada. A total of 318 350 community-dwelling adults, aged 65 years and older, newly identified with dementia, followed for up to 1 year. Eighteen indicators of primary care performance and health service use were assessed. Approximately 60% of the study population were women. Few differences in the indicators were observed between sexes, although men had fewer diagnoses first recorded by the family physician, more visits to noncognition specialists, less use of home care, more hospitalizations and readmissions, and longer discharge delays. Most indicators remained relatively stable over time for both men (median relative change = 13.7%; interquartile range [IQR] = 4.5%-29.7%) and women (median relative change = 15.7%; IQR = 5.9%-31.5%). Notable improvements over time for both sexes included access to an interprofessional primary care team, use of home care, and decreased use of long-term care. Areas of worsening included a higher occurrence of emergency department visits, lower continuity of care, and longer discharge delays. These findings raise awareness on the similarities and differences in management and health system use for men and women newly diagnosed with dementia, particularly the imbalance in hospital and home care use. As health systems continue to adapt to meet the needs of the growing dementia population, policy makers and clinicians should be mindful to develop care plans and interventions that consider the influence of sex on the need for services. J Am Geriatr Soc 68:1056-1063, 2020.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1056-1063Subventions
Organisme : CIHR
ID : CNA-137794
Pays : Canada
Informations de copyright
© 2020 The American Geriatrics Society.
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