RT Journal Article
SR Electronic
T1 Interprofessional Primary Care and Acute Care Hospital Use by People With Dementia: A Population-Based Study
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 512
OP 518
DO 10.1370/afm.2881
VO 20
IS 6
A1 Nadia Sourial
A1 Tibor Schuster
A1 Susan E. Bronskill
A1 Claire Godard-Sebillotte
A1 Jacob Etches
A1 Isabelle Vedel
YR 2022
UL http://www.annfammed.org/content/20/6/512.abstract
AB PURPOSE Interprofessional primary care has the potential to optimize hospital use for acute care among people with dementia. We compared 1-year emergency department (ED) visits and hospitalizations among people with dementia enrolled in a practice having an interprofessional primary care team with those enrolled in a physician-only group practice.METHODS A population-based, repeated cohort study design was used to extract yearly cohorts of 95,323 community-dwelling people in Ontario, Canada, newly identified in administrative data with dementia between April 1, 2005 and March 31, 2015. Patient enrollment in an interprofessional practice or a physician-only practice was determined at the time of dementia diagnosis. We used propensity score–based inverse probability weighting to compare study groups on overall and nonurgent ED visits as well as on overall and potentially avoidable hospitalizations in the 1 year following dementia diagnosis.RESULTS People with dementia enrolled in a practice having an interprofessional primary care team were more likely to have ED visits (relative risk = 1.03; 95% CI, 1.01-1.05) and nonurgent ED visits (relative risk = 1.22; 95% CI, 1.18-1.28) compared with those enrolled in a physician-only primary care practice. There was no evidence of an association between interprofessional primary care and hospitalization outcomes.CONCLUSIONS Interprofessional primary care was associated with increased ED use but not hospitalizations among people newly identified as having dementia. Although interprofessional primary care may be well suited to manage the growing and complex dementia population, a better understanding of the optimal characteristics of team-based care and the reasons leading to acute care hospital use by people with dementia is needed.