Healthcare Utilization in Different Stages among Patients with Dementia: A Nationwide Population-Based Study

Yu-Han Chen, Yi-Chen Lai, Yu-Cih Wu, Jun Sasaki, Kang-Ting Tsai and Chung-Han Ho
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Yu-Han Chen: Department of Family Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
Yi-Chen Lai: Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan 709, Taiwan
Yu-Cih Wu: Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan
Jun Sasaki: Yushokai Medical Corporation, Tokyo 105-0004, Japan
Kang-Ting Tsai: Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan 710, Taiwan
Chung-Han Ho: Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan

IJERPH, 2021, vol. 18, issue 11, 1-15

Abstract: To evaluate the trend of healthcare utilization among patients with dementia (PwD) in different post-diagnosis periods, Taiwan’s nationwide population database was used in this study. PwD were identified on the basis of dementia diagnoses during 2002–2011. We further subdivided the cases into 10 groups from the index year to the 10th year after diagnosis. The frequency of emergency department visits and hospitalizations, the length of stay, outpatient and department visits, and the number of medications used were retrieved. The Joinpoint regression approach was used to estimate the annual percent change (APC) of healthcare utilization. The overall trend of healthcare utilization increased with the progression of dementia, with a significant APC during the first to second year after diagnosis ( p < 0.01), except that the frequency of outpatient visits showed a decreasing trend with a significant APC from the first to fifth year. All sex- and age-stratified analyses revealed that male gender and old age contributed to greater use of healthcare services but did not change the overall trend. This study provides a better understanding of medical resource utilization across the full spectrum of dementia, which can allow policymakers, physicians, and caregivers to devise better care plans for PwD.

Keywords: dementia; healthcare utilization; medical services; national health insurance (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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