TY - JOUR
T1 - Care Needs and clinical outcomes of older people with dementia
T2 - A population-based propensity score-matched cohort study
AU - Hsiao, Fei Yuan
AU - Peng, Li Ning
AU - Wen, Yu Wen
AU - Liang, Chih Kuang
AU - Wang, Pei Ning
AU - Chen, Liang Kung
N1 - Publisher Copyright:
© 2015 Hsiao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objective: To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia. Design: A nationwide propensity score-matched cohort study. Setting National Health Insurance Research database. Participants: A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649). Measurements: Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days. Results: Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%), and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]). Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001). Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR) =1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001) and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001) compared to matched controls. Conclusions: When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.
AB - Objective: To explore the healthcare resource utilization, psychotropic drug use and mortality of older people with dementia. Design: A nationwide propensity score-matched cohort study. Setting National Health Insurance Research database. Participants: A total of 32,649 elderly people with dementia and their propensity-score matched controls (n=32,649). Measurements: Outpatient visits, inpatient care, psychotropic drug use, in-hospital mortality and all-cause mortality at 90 and 365 days. Results: Compared to the non-dementia group, a higher proportion of patients with dementia used inpatient services (1 year after index date: 20.91% vs. 9.55%), and the dementia group had more outpatient visits (median [standard deviation]: 7.00 [8.87] vs. 3.00 [8.30]). Furthermore, dementia cases with acute admission had the highest psychotropic drug utilization both at baseline and at the post-index dates (difference-in-differences: all <0.001). Dementia was associated with an increased risk of all-cause mortality (90 days, Odds ratio (OR) =1.85 [95%CI 1.67-2.05], p<0.001; 365 days, OR=1.59 [1.50-1.69], p<0.001) and in-hospital mortality (90 days, OR=1.97 [1.71-2.27], p<0.001; 365 days, OR=1.82 [1.61-2.05], p<0.001) compared to matched controls. Conclusions: When older people with dementia are admitted for acute illnesses, they may increase their use of psychotropic agents and their risk of death, particularly in-hospital mortality.
UR - http://www.scopus.com/inward/record.url?scp=84943268733&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0124973
DO - 10.1371/journal.pone.0124973
M3 - Article
C2 - 25955163
AN - SCOPUS:84943268733
SN - 1932-6203
VL - 10
JO - PLoS ONE
JF - PLoS ONE
IS - 5
M1 - e0124973
ER -