Predictors of emergency department visit among people with dementia in Taiwan

Mao-Hsuan Huang; Chia-Fen Tsai; Chih-Ming Cheng; Yung-Shuan Lin; Wei-Ju Lee; Yu-Shan Kuo; Yee-Lam E Chan; Jong-Ling Fuh

doi:10.1016/j.archger.2022.104701

Predictors of emergency department visit among people with dementia in Taiwan

Arch Gerontol Geriatr. 2022 Jul-Aug:101:104701. doi: 10.1016/j.archger.2022.104701. Epub 2022 Apr 4.

Authors

Mao-Hsuan Huang¹, Chia-Fen Tsai², Chih-Ming Cheng², Yung-Shuan Lin³, Wei-Ju Lee⁴, Yu-Shan Kuo⁵, Yee-Lam E Chan⁶, Jong-Ling Fuh⁷

Affiliations

¹ Department of Psychiatry, YuanShan and Suao Branches of Taipei Veterans General Hospital, Ilan, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taiwan.
³ Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan; Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.
⁵ Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.
⁷ Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang-Ming Chiao Tung University, Taipei, Taiwan. Electronic address: jlfuh@vghtpe.gov.tw.

PMID: 35398715
DOI: 10.1016/j.archger.2022.104701

Abstract

Background: We aimed to identify predictors of emergency department (ED) visit by people with dementia (PWDs) and their caregivers with a one-year follow-up in a country with public health system.

Methods: Data were collected from a national dementia registration survey. Andersen's Behavioral Model of Health Services Use was used. Variables such as demographic data of PWDs and their caregivers, caregivers' monthly income, the relationship between PWD and caregivers, the severity of dementia (clinical dementia rating, CDR), physical comorbidities, cognitive function (mini-mental state examination, MMSE), and activities of daily living of PWDs, the caregiver burden, and neuropsychiatric symptoms (assessed by the Neuropsychiatric Inventory Questionnaire) were included in the analyses.

Results: A total of 1,227 PWDs-caregiver dyads completed the survey, and 405 (33%) of PWDs visited ED during the one-year follow-up. Multivariable logistic analyses revealed that older age of PWDs (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01-1.05), more severe dementia (CDR; OR = 1.42, 95% CI = 1.09-1.86), higher cognitive function (MMSE; OR = 1.04, 95% CI = 1.01-1.07), and having a female family caregiver (OR = 1.50, 95% CI = 1.13-2.01) were predictors of ED visit.

Conclusion: Our study results provided information for healthcare providers and policy makers to target models of care that support PWD and their caregivers and reduce the need for ED visits.

Keywords: Cognitive impairment; Dementia; Emergency department.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living*
Caregivers / psychology
Dementia* / epidemiology
Dementia* / psychology
Emergency Service, Hospital
Female
Humans
Taiwan / epidemiology