Data from University of Bremen Advance Knowledge in Dementia (The influence of primary care quality on nursing home admissions in a multimorbid population with and without dementia in Germany: a retrospective cohort study using health insurance …): Neurodegenerative Diseases and Conditions – Dementia

Hospital & Nursing Home Daily

2022 JAN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital & Nursing Home Daily -- Investigators publish new report on dementia. According to news reporting originating from the University of Bremen by NewsRx correspondents, research stated, “Multimorbidity poses a challenge for high quality primary care provision for nursing care-dependent people with (PWD) and without (PWOD) dementia. Evidence on the association of primary care quality of multimorbid PWD and PWOD with the event of a nursing home admission (NHA) is missing.”

Funders for this research include Universitat Bremen Funder DOI: 10.13039/501100007837 Award:.

Our news reporters obtained a quote from the research from University of Bremen: “This study aimed to investigate the contribution of individual quality of primary care for chronic diseases in multimorbid care-dependent PWD and PWOD on the duration of ongoing residence at home before the occurrence of NHA. We conducted a retrospective cohort study among elderly care-dependent PWD and PWOD in Germany for six combinations of chronic diseases using statutory health insurance claims data (2007-2016). Primary care quality was measured by 21 process and outcome indicators for hypertension, diabetes, depression, chronic obstructive pulmonary disease and heart failure. The primary outcome was time to NHA after initial onset of care-dependency. Multivariable Cox proportional hazard models were used to compare the time-to-event between PWD and PWOD. Among 5876 PWD and 12,837 PWOD 5130 NHA occurred. With the highest proportion of NHA for PWD with hypertension and depression and for PWOD with hypertension, diabetes and depression. Average duration until NHA ranged from 6.5 to 8.9 quarters for PWD and from 9.6 to 13.5 quarters for PWOD. Adjusted analyses show consistent associations of the quality of diabetes care with the duration of remaining in one’s own home regardless of the presence of dementia. Process indicators assessing guideline-fidelity are associated with remaining in one’s home longer, while indicators assessing complications, such as emergency inpatient treatment (HR = 2.67, 95% CI 1.99-3.60 PWD; HR = 2.81, 95% CI 2.28-3.47 PWOD) or lower-limb amputation (HR = 3.10, 95% CI 1.78-5.55 PWD; HR = 2.81, 95% CI 1.94-4.08 PWOD) in PWD and PWOD with hypertension and diabetes, increase the risk of NHA.”

According to the news editors, the research concluded: “The quality of primary care provided to care-dependent multimorbid PWD and POWD, influences the time individuals spend living in their own homes after onset of care-dependency before a NHA. Health care professionals should consider possibilities and barriers of guideline-based, coordinated care for multimorbid care-dependent people. Further research on quality indicator sets that acknowledge the complexity of care for multimorbid elderly populations is needed.”

For more information on this research see: The influence of primary care quality on nursing home admissions in a multimorbid population with and without dementia in Germany: a retrospective cohort study using health insurance claims data. BMC Geriatrics, 2022,22(1):1-13. (BMC Geriatrics - http://bmcgeriatr.biomedcentral.com). The publisher for BMC Geriatrics is BMC.

A free version of this journal article is available at https://doi.org/10.1186/s12877-021-02731-8.

Our news journalists report that more information may be obtained by contacting Kathrin Seibert, Faculty 11: Human and Health Sciences, Institute for Public Health and Nursing Research, University of Bremen. Additional authors for this research include Susanne Stiefler, Dominik Domhoff, Karin Wolf-Ostermann, Dirk Peschke.