Predictors of emergency department visit among people with dementia in Taiwan

Abstract

BackgroundWe 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. MethodsData 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. ResultsA 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. ConclusionOur 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.