Describing trends in the quality of health care and services for men and women living with dementia Developing topics

• Published in: Alzheimer's & dementia Vol. 16; no. S10
• Main Authors: Bui, Tammy X, Arsenault‐Lapierre, Genevieve, Sourial, Nadia, Godard‐Sebillotte, Claire, Rochette, Louis, Vedel, Isabelle
• Format: Journal Article
• Language: English
• Published: 01.12.2020
• ISSN: 1552-5260; 1552-5279
• DOI: 10.1002/alz.047217

Abstract Background As the Canadian population ages, challenges have emerged with the quality and healthcare utilization of services for persons living with dementia (PWD). These challenges may be exacerbated when we consider the sex inequalities. A disconcerting trend in sex differences has arisen among older adult women, where they are more disadvantaged compared to older men when seeking and receiving treatment. The aims of this study are to describe the quality of dementia care and healthcare utilization among PWD by sex. Methods The study will employ a repeated annual cross‐sectional cohort design over 15 years using linked administrative databases to examine health service use data. All incident cases of dementia in community‐dwelling persons aged 65 and over occurring between April 1 st and March 31 st for each year will be included. Dementia diagnosis will be ascertained using a validated algorithm. Quality of care indicators include: most regularly seen doctor (Overall UPC index), hospitalization for ambulatory care sensitive conditions, continuity of care (Bice‐Boxeman index), degree of coordination (30‐day hospital readmission). Healthcare utilization indicators include: emergency department visits, hospitalizations, alternate level of care, visits to primary care physicians and cognition specialists, long‐term care admission and mortality. Data will be stratified by sex. Results 237,259 people (62.7% women) were included in the analyses. Variations over time and between men and women are observed in healthcare utilization indicators including emergency department visits, hospitalizations, alternate level of care, visits to primary care physicians and cognition specialists, long‐term care admission and mortality. For each indicator, graphs will be presented with an annual rate, adjusted for age and follow‐up time in the study. Conclusion Addressing the knowledge gap in the quality of care and healthcare utilization in PWD by sex is essential to inform decision‐makers for the implementation of adequate policies to promote equity in dementia care and ultimately improve the health among men and women living with dementia.