Utilization patterns of ambulatory medical care before and after the diagnosis of dementia in Germany--results of a case-control study

Abstract

Aims: To analyze how the diagnosis of dementia changes the utilization of the ambulatory medical care services in the German statutory health insurance.

Methods: In this case-control study, claims data of 1,848 insurants aged >or=65 years with incident dementia and 7,392 matched controls were compared regarding their utilization of ambulatory medical care services.

Results: We found an increase in the utilization of ambulatory medical care services by demented patients of 50% in the year before and of 40% in the year after the incidence, predominantly in primary care and neurology/psychiatry settings. A negative interaction effect of age and gender (p <or= 0.000) was found regarding the number of visited physicians.

Conclusion: Service utilization by demented patients increases already within the year before the first diagnosis and stays on a relatively high level within the year after. Especially (female) patients aged 80 years and older at dementia onset ought to be observed to prevent a possible undersupply.