Rural and urban differences in quality of dementia care of persons with dementia and caregivers across all domains: a systematic review

被引:27
作者
Arsenault-Lapierre, Genevieve [1 ]
Bui, Tammy X. X. [1 ]
Le Berre, Melanie [2 ]
Bergman, Howard [3 ]
Vedel, Isabelle [1 ,3 ]
机构
[1] Jewish Gen Hosp, Lady Davis Inst Med Res, 5858 Ch Cote Des Neiges,Suite 300, Montreal, PQ H3S 1Z1, Canada
[2] Univ Montreal, Inst Univ Geriatrie Montreal, 4565 Chemin Queen Mary, Montreal, PQ H3W 1W5, Canada
[3] McGill Univ, Dept Family Med, 5858 Ch Cote Des Neiges,Suite 300, Montreal, PQ H3S 1Z1, Canada
基金
加拿大健康研究院;
关键词
Rural Population; Rural Health or Rural Health Services; Quality of Healthcare; Dementia; ALZHEIMERS-DISEASE; INCOME COUNTRIES; TEMPORAL TRENDS; OLDER-ADULTS; MORTALITY; PEOPLE; HOSPITALIZATIONS; DISPARITIES; DIAGNOSIS; SURVIVAL;
D O I
10.1186/s12913-023-09100-8
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BackgroundThere are challenges in healthcare service delivery in rural areas, and this may be especially true for persons with dementia, who have higher needs to access to the healthcare system, and may have difficulties to commute easily and safely to these services. There is a growing body of literature regarding geographical disparities, but there is no comprehensive systematic review of geographical differences in persons with dementia across all domains of care quality. Therefore, the objective of this study is to conduct a systematic review of the literature on rural and urban differences in quality of dementia care outcomes of persons with dementia across all quality-of-care domains.MethodsWe performed a digital search in Ovid MEDLINE on July 16, 2019, updated on May 3, 2021, for French or English records. We selected studies that reported outcome from at least one domain of quality of dementia care (Access, Integration, Effective Care, Efficient Care, Population Health, Safety, and Patient-Centered) in both rural and urban persons with dementia or caregivers. We used rigorous, systematic methods for screening, selection, data extraction and we analyzed outcomes reported by at least two studies using vote counting and appraised the certainty of evidence. Finally, we explored sources of heterogeneity.ResultsFrom the 38 included studies, we found differences in many dementia care domains. Rural persons with dementia had higher mortality rates (Population Health), lower visits to any physicians (Access), more hospitalizations but shorter stays (Integration), higher antipsychotic medications (Safety), lower use of home care services and higher use of nursing home (Patient-Centered Care) compared to urban persons with dementia.ConclusionsThis comprehensive portrait of rural-urban differences in dementia care highlights possible geographically based inequities and can be used by researchers and decision makers to guide development of more equitable dementia care policies.
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页数:15
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共 96 条
  • [1] Drug persistency of cholinesterase inhibitors for patients with dementia of Alzheimer type in Korea
    Ahn, So-Hyeon
    Choi, Nam-Kyong
    Kim, Ye-Jee
    Seong, Jong-Mi
    Shin, Ju-Young
    Jung, Sun-Young
    Park, Byung-Joo
    [J]. ARCHIVES OF PHARMACAL RESEARCH, 2015, 38 (06) : 1255 - 1262
  • [2] Measuring health inequalities: a systematic review of widely used indicators and topics
    Albert-Ballestar, Sergi
    Garcia-Altes, Anna
    [J]. INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH, 2021, 20 (01)
  • [3] Alzheimer's Disease International , 2015, WOM DEM GLOB RES REV
  • [4] [Anonymous], 2021, GLOBAL HLTH WORKFORC
  • [5] [Anonymous], 2006, Geographic distribution of physicians in Canada: Beyond how many and where? [Executive summary]
  • [6] Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review
    Basu, Sanjay
    Andrews, Jason
    Kishore, Sandeep
    Panjabi, Rajesh
    Stuckler, David
    [J]. PLOS MEDICINE, 2012, 9 (06) : 19
  • [7] The temporal trend and distribution characteristics in mortality of Alzheimer's disease and other forms of dementia in China: Based on the National Mortality Surveillance System (NMS) from 2009 to 2015
    Bo, Zhenyan
    Wan, Yang
    Meng, Steven Siyao
    Lin, Tengfei
    Kuang, Weihong
    Jiang, Lijun
    Qiu, Peiyuan
    [J]. PLOS ONE, 2019, 14 (01):
  • [8] Pharmacotherapy of dementia in Germany: Results from a nationwide claims database
    Bohlken, Jens
    Schulz, Mandy
    Rapp, Michael A.
    Baetzing-Feigenbaum, Joerg
    [J]. EUROPEAN NEUROPSYCHOPHARMACOLOGY, 2015, 25 (12) : 2333 - 2338
  • [9] Missed and Delayed Diagnosis of Dementia in Primary Care Prevalence and Contributing Factors
    Bradford, Andrea
    Kunik, Mark E.
    Schulz, Paul
    Williams, Susan P.
    Singh, Hardeep
    [J]. ALZHEIMER DISEASE & ASSOCIATED DISORDERS, 2009, 23 (04) : 306 - 314
  • [10] Trajectories of health system use and survival for community-dwelling persons with dementia: a cohort study
    Bronskill, Susan E.
    Maclagan, Laura C.
    Walker, Jennifer D.
    Guan, Jun
    Wang, Xuesong
    Ng, Ryan
    Rochon, Paula A.
    Yates, Erika A.
    Vermeulen, Marian J.
    Maxwell, Colleen J.
    [J]. BMJ OPEN, 2020, 10 (07):