Who Is Providing the Predominant Care for Older Adults With Dementia?

被引：26

作者：

Yang, Mia ^{[1
]}

Chang, Chiang-Hua ^{[2
]}

Carmichael, Donald ^{[2
]}

Oh, Esther S. ^{[1
,3
,4
,5
]}

Bynum, Julie P. W. ^{[2
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

[2] Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA

[3] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA

[4] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA

[5] Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21205 USA

来源：

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2016年 / 17卷 / 09期

关键词：

Predominant provider; dementia; primary care; specialist; long-term care; Medicare; ALZHEIMERS-DISEASE; FAMILY PHYSICIANS;

D O I：

10.1016/j.jamda.2016.04.026

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objectives: To identify which clinical specialties are most central for care of people with dementia in the community and long-term care (LTC) settings. Design: Cross-sectional analysis. Participants: Fee-for-service Medicare beneficiaries aged >= 65 years with dementia. Measurements: Specialty, categorized into primary care (internal or family medicine, geriatrics, or nurse practitioners [NPs]) versus other specialties, of the predominant provider of care (PPC) for each patient, defined by providing the most ambulatory visits. Results: Among 2,598,719 beneficiaries with dementia, 74% lived in the community and 80% had a PPC in primary care. In LTC, 91% had primary care as their PPC compared with 77% in the community (P<.001). Cardiology and neurology were the most frequent specialties. NPs were PPCs for 19% of dementia patients in LTC versus 7% in the community (P<.001). Conclusion: It is unknown whether specialists are aware of their central role for many dementia patients' care needs. In LTC, NPs play the lead role as PPCs. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

引用

页码：802 / 806

页数：5

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