Avoidable Hospitalizations in Persons with Dementia: a Population-Wide Descriptive Study (2000-2015)

Area of Science:

• Gerontology
• Health Services Research
• Public Health

Background:

• Avoidable hospitalizations in community-dwelling persons with dementia are a significant concern.
• The impact of primary care reforms on these hospitalizations remains largely unknown.

Purpose of the Study:

• To investigate trends in avoidable hospitalizations among community-dwelling persons with dementia.
• To assess the effect of a province-wide primary care reform on these trends.

Main Methods:

• Population-based study of 192,144 individuals with incident dementia in Quebec (2000-2015).
• Utilized provincial health administrative data to analyze Ambulatory Care Sensitive Condition (ACSC) hospitalizations and 30-day readmissions.
• Examined rates of delayed hospital discharge (alternate level of care - ALC).

Main Results:

• Ambulatory Care Sensitive Condition (ACSC) hospitalization rates and 30-day readmission rates remained constant.
• Delayed hospital discharge (ALC) rates significantly decreased by 24.6% over the study period.
• No significant improvement was observed for most hospitalization outcomes despite primary care reforms.

Conclusions:

• Primary care reforms have not effectively reduced most types of avoidable hospitalizations in persons with dementia.
• A notable decrease in delayed hospital discharge suggests potential benefits in specific areas.
• Evidence-based policies are crucial to prevent avoidable hospitalizations in this vulnerable population.