Open AccessCommunity‐based serious illness care for patients with dementia
Author(s) -
Noah Hannah,
Daaleman Timothy P.,
Kistler Christine E.
Publication year - 2018
Publication title -
alzheimer's and dementia: translational research and clinical interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.49
H-Index - 30
ISSN - 2352-8737
DOI - 10.1016/j.trci.2018.06.011
Subject(s) - dementia , medicine , gerontology , emergency department , population , health care , psychological intervention , medline , multidisciplinary approach , psychiatry , disease , environmental health , pathology , political science , law , economics , economic growth , social science , sociology
Cognitive and psychiatric disorders are prevalent in the homebound population, with dementia and depression being especially common [1]. One intervention that could potentially improve the care of those with dementia is community-based serious illness care (CBSC). CBSC programs such as home-based primary care have been shown to reduce cost and improve care for homebound patients [2]. Patients enrolled in the Veteran Affairs’ Home-Based Primary Care program cost the Veteran Affairs health care system 24% less on health expenditures, compared with the 6-month period before enrollment [3]. However, CBSC programs have not been evaluated for their effect on patient outcomes in those with dementia. Because dementia patients require expensive care and suffer from frequent acute illnesses near the end of life, CBSC may affect emergency department (ED) visits and number of hospitalizations in this population differently [4]. This study describes patients in a multidisciplinary CBSC program called the “Reaching out to Enhance the Health of Adults in their Communities and Homes” (REACH) program by dementia status. Because this population may have different needs compared with patients without dementia, we examined differences in patient characteristics between those with and without dementia, including the associations between dementia and outcomes post-REACH program initiation.