Utilization patterns of ambulatory medical care before and after the diagnosis of dementia in Germany--results of a case-control study.
OBJECTIVE
To analyze how the diagnosis of dementia changes the utilization of the ambulatory medical care services in the German statutory health insurance.


METHODS
In this case-control study, claims data of 1,848 insurants aged >or=65 years with incident dementia and 7,392 matched controls were compared regarding their utilization of ambulatory medical care services.


RESULTS
We found an increase in the utilization of ambulatory medical care services by demented patients of 50% in the year before and of 40% in the year after the incidence, predominantly in primary care and neurology/psychiatry settings. A negative interaction effect of age and gender (p <or= 0.000) was found regarding the number of visited physicians.


CONCLUSIONS
Service utilization by demented patients increases already within the year before the first diagnosis and stays on a relatively high level within the year after. Especially (female) patients aged 80 years and older at dementia onset ought to be observed to prevent a possible undersupply.
Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Marion
M
Eisele
Hendrik
H
van den Bussche
Daniela
D
Koller
Birgitt
B
Wiese
Hanna
H
Kaduszkiewicz
Wolfgang
W
Maier
Gerd
G
Glaeske
Susanne
S
Steinmann
Karl
K
Wegscheider
Gerhard
G
Schön
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D005260:Female; D005858:Germany; D006285:Health Planning; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D020380:Needs Assessment; D058007:Physicians, Primary Care / Q000706:statistics & numerical data*; D012016:Reference Values