[Utilization patterns of dementia patients in the light of statutory health insurance data]

In describing the patterns of utilization of healthcare services by dementia patients in comparison to age- and sex-matched controls the study was to provide information on special care needs of patients with dementia concerning somatic diseases. A representative sample of insured individuals from 1998 to 2002 (the "Versichertenstichprobe AOK Hessen/KV Hessen") provided the database. Patients with dementia were defined according to the ICD-coded billing diagnoses. Regarding general practitioner visits, patients with dementia have approx. 11 additional contacts per year compared to their controls. A smaller percentage of patients with dementia present to a specialist (excluding neurologists/psychiatrists). Furthermore, the two groups differ as to the kind of specialists visited, which in turn is associated with different service and prescription patterns. The study was not able to clarify whether the differences are possibly due to the GPs' prioritization of treatment of dementia patients. Both physicians and nurses should be sensitized to the possibility that dementia patients may not be able to explicitly mention existing diseases and impairments (such as cardiovascular and sensory disorders, pain). Moreover, physicians and other professionals involved in the management of dementia patients should be trained to pay special attention to the particular care-related problems (pressure ulcers, infections or inadequate fluid intake).