[Practice variation in diagnostic testing for dementia; a nation-wide overview].

Area of Science:

• Neurology
• Healthcare Management
• Medical Diagnostics

Background:

• Dementia diagnosis relies on various ancillary services, but their utilization can differ between healthcare institutions.
• Understanding diagnostic practice variation is crucial for improving dementia care pathways.

Purpose of the Study:

• To investigate and quantify the variation in diagnostic strategies for dementia among Dutch hospitals.
• To compare diagnostic approach differences between academic medical centers, training hospitals, and general hospitals.

Main Methods:

• A retrospective analysis of Dutch health insurer claims data from 2015-2018.
• Inclusion of 71 hospitals diagnosing over 50 dementia cases in 2018.
• Categorization of hospitals into academic medical centers (AMCs), training hospitals (THs), and general hospitals (GHs).

Main Results:

• Significant variation observed in the use of MRI/CT-imaging, neuropsychological assessment, cerebrospinal fluid examination, PET/SPECT-imaging, and electroencephalography.
• Practice variation was consistent across AMCs, THs, and GHs.
• Ancillary diagnostic use decreased with increasing patient age.

Conclusions:

• Dutch hospitals exhibit considerable heterogeneity in dementia diagnostic methods and frequency.
• Factors influencing this variation may include limited evidence on diagnostic accuracy, differing preferences, and resource availability.
• Further research into this heterogeneity is needed to establish optimal, patient-centered diagnostic strategies.