Care trajectories around a first dementia diagnosis in patients with serious mental illness.
bipolar disorder
care trajectory
dementia
healthcare services
schizophrenia
Journal
Geriatrics & gerontology international
ISSN: 1447-0594
Titre abrégé: Geriatr Gerontol Int
Pays: Japan
ID NLM: 101135738
Informations de publication
Date de publication:
06 May 2024
06 May 2024
Historique:
revised:
19
02
2024
received:
02
11
2023
accepted:
21
04
2024
medline:
7
5
2024
pubmed:
7
5
2024
entrez:
6
5
2024
Statut:
aheadofprint
Résumé
To develop a typology of care trajectories (CTs) 1 year before and after a first dementia diagnosis in individuals aged ≥65 years, with prevalent schizophrenia or bipolar disorder. This was a longitudinal, retrospective cohort study using health administrative data (1996-2016) from Quebec (Canada). We selected patients aged ≥65 years with an incident diagnosis of dementia between 1 January 2014 and 31 December 2016, and a diagnosis of schizophrenia and/or or bipolar disorder. A CT typology was generated by a multidimensional state sequence analysis based on the "6 W" model of CTs. Three dimensions were considered: the care setting ("where"), the reason for consultation ("why") and the specialty of care providers ("which"). In total, 3868 patients were categorized into seven distinct types of CTs, with varying patterns of healthcare use and comorbidities. Healthcare use differed in terms of intensity, but also in its distribution around the diagnosis. For instance, whereas one group showed low healthcare use, healthcare use abruptly increased or decreased after the diagnosis in other groups, or was equally distributed. Other significant differences between CTs included mortality rates and use of long-term care after the diagnosis. Most patients (67%) received their first dementia diagnosis during hospitalization. Our innovative approach provides a unique insight into the complex healthcare patterns of people living with serious mental illness and dementia, and provides an avenue to support data-driven decision-making by highlighting fragility areas in allocating care resources. Geriatr Gerontol Int 2024; ••: ••-••.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Centre de recherche du CHUS (CRCHUS)
Organisme : Department of Family and Emergency Medicine at the Université de Sherbrooke
Organisme : Janssen (division of Johnson & Johnson) and the Ministère de l'Économie et de l'Innovation (MEI), within the framework of Données de recherche en contexte réel-Partenariat Innovation-Québec-Janssen (PIQJ) administered by the Quebec Health Research Funds (FRQS)
Organisme : Alzheimer Society Research Program
Informations de copyright
© 2024 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.
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