How Does Utilization of Health Care Services Change in People with Dementia Served by Dementia Care Networks? Results of the Longitudinal, Observational DemNet-D-Study
Affiliations: [a] German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Greifswald, Germany
| [b] Department of Health and Nursing, Campus Alt-Saarbrücken, University of Applied Sciences, School of Social Sciences, Saarbrücken, Germany
| [c] German Center for Neurodegenerative Diseases (DZNE), Site Witten, Witten, Germany
| [d] Institute for Applied Social Sciences (IfaS), Baden-Wuerttemberg Cooperative State University Stuttgart, Fakultät Sozialwesen, Stuttgart, Germany
| [e] Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| [f] Institute for Community Medicine (ICM), University Medicine Greifswald, Greifswald, Germany
Correspondence:
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Correspondence to: Jochen René Thyrian, German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489 Greifswald, Germany. Tel.: +49 3834 86 75 92; Fax: +49 3834 86 19551; E-mail: rene.thyrian@dzne.de.
Abstract: Background:There is no common definition for the Dementia Care Network (DCN). They are heterogeneous and there is no general, longitudinal evidence for the effects of DCN. Objective:We describe changes in utilization of health services by people served by dementia care networks in Germany and factors associated with those changes over time. Methods:Primary data was assessed in 560 people with dementia (PwD) and their caregivers supported by DCN in Germany; sociodemographic and clinical variables, utilization of services; DCN were characterized according to governance. The design: observational study with face-to-face interviews at two time points over a period of one year. Data was assessed via semi-structured interviews at the participants’ homes. Results:Utilization of health services in this study is consistently higher than reported for the general population and does not significantly change over time. The strongest predictor of utilization of any service after one year was the use of this service at baseline (OR from 3.23 to 44.16). Higher activities of daily functioning increased the chances to utilize specialist physicians (OR = 1.32; 95% -CI: 1.08–1.63) or occupational therapy (OR = 1.24; 95% -CI: 1.02–1.50) significantly. Being a female decreased chances to utilize specialist physicians (OR = 0.57; 95% -CI: 0.37–0.87) and increased the chances to utilize no services (OR = 2.08; 95% -CI: 1.29–3.33). Conclusion:While health care acknowledges the importance and benefits of dementia care networks (i.e., in Germany, the results were considered in new German legislation (SGB XI)), further research is needed to define this kind of service delivery to facilitate comparison as well as promote evidence-based implementation.
Keywords: Care network, dementia, Germany, health services
