Preparedness of China's health care system to provide access to a disease-modifying Alzheimer's treatment

被引:9
作者
Mattke, Soeren [1 ,3 ]
Loh, Wei Kok [2 ]
Yuen, Kah-Hung [2 ]
Yoong, Joanne [2 ]
机构
[1] Univ Southern Calif, Ctr Improving Chron Illness Care, Los Angeles, CA USA
[2] Res Impact, Singapore, Singapore
[3] Univ Southern Calif, Ctr Improving Chron Illness Care, Dornsife,635 Downey Way, 505N, Los Angeles, CA 90089 USA
关键词
Alzheimer's disease; capacity; China; disease-modifying treatment; preparedness; MILD COGNITIVE IMPAIRMENT; DEMENTIA; CHALLENGES; INSURANCE; REFORM;
D O I
10.1002/alz.13348
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
INTRODUCTIONAlthough the majority of patients with Alzheimer's disease (AD) reside in low-and middle-income countries, little is known of the infrastructure in these countries for delivering emerging disease-modifying treatments. METHODSWe analyze the preparedness of China, the world's most populous middle-income country, using desk research, expert interviews and a simulation model. RESULTSOur findings suggest that China's health care system is ill-prepared to provide timely access to Alzheimer's treatment. The current pathway, in which patients seek evaluation in hospital-based memory clinics without a prior assessment in primary care, would overwhelm existing capacity. Even with triage using a brief cognitive assessment and a blood test for the AD pathology, predicted wait times would remain over 2 years for decades, largely due to limited capacity for confirmatory biomarker testing despite adequate specialist capacity. DISCUSSIONClosing this gap will require the introduction of high-performing blood tests, greater reliance on cerebrospinal fluid (CSF) testing, and expansion of positron emission tomography (PET) capacity.
引用
收藏
页码:5596 / 5604
页数:9
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