失智症與非失智症長者之照顧者醫療服務利用之比較

To compare the healthcare utilization and expenditures between the caregivers of elderly adults with or without dementia who were in Ten-year Long Term Care Project (TLTCP) in Taiwan. Methods: Data were extracted from the population-based datasets of the Long-Term Care Service Management System and the National Health Insurance in Taiwan. 10,771 individuals who were the caregivers of elderly adults aged ≥65 years in the TLTCP during 2008-2013 were included. Multiple logistic regression and multiple linear regression were used to compare the 1-year healthcare utilization and expenditures between the caregivers of elderly adults with or without dementia, including outpatients, emergency departments (EDs), and hospitalizations, after their care recipients being first time prescribed with LTC services. Results: In general, no significant differences were observed between the two groups. However, caregivers who cared for patients with dementia with mild disabilities had significantly 20.6% higher per ED fees (p ＜ 0.01) and 31.9% higher ED fees (p ＜ 0.01). Caregivers who cared for patients with dementia with severe disabilities had significantly 0.22 higher hospitalization visits (p ＜ 0.05). Conclusions: In general, there is no difference in the use of healthcare services between the caregivers of elderly adults with or without dementia. Nevertheless, dementia caregivers, especially those caring for patients with mild dementia, are more likely to neglect their own health and hence tend to use more acute care healthcare resources. These results suggest policymakers to provide additional respite care services to allow caregivers time to seek for primary healthcare resources.