gms | German Medical Science

16. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

4. - 6. Oktober 2017, Berlin

Evaluation of Dementia Care Networks in Germany – An example for translational health care research

Meeting Abstract

Suche in Medline nach

  • Bernhard Norbert Michalowsky - Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE) e.V., Greifswald, Germany
  • Jochen René Thyrian - Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Greifswald, Germany
  • Wolfgang Hoffmann - Universitätsmedizin Greifswald, Greifswald, Germany

16. Deutscher Kongress für Versorgungsforschung (DKVF). Berlin, 04.-06.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP157

doi: 10.3205/17dkvf390, urn:nbn:de:0183-17dkvf3903

Veröffentlicht: 26. September 2017

© 2017 Michalowsky et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: In Germany, 75% of the persons with dementia (PWD) are community-dwelling. Society and health policy emphasize care for highly dependent older people at their home as long as possible. However, dementia implies a complex interdisciplinary and multi-professional management. Whereas the health care system offers all necessary forms of treatment and care, there is no systematic coordination of medical and care services. Dementia care networks (DCN) aim to overcome this problem to improve treatment and care for people with dementia by integration of relevant health care actors (including GP, specialist physician, pharmacist, nursing care, physiotherapy, ergotherapy). Thus, DCN are a promising approach to improve coordination and to avoid interface problems. However, empirical data concerning the effectiveness of such DCN as well as factors that influence effectiveness and sustainability of DCN are currently missing.

Aims: (1) To analyze the utilization of dementia-specific treatment and care in DCN; (2) to identify (financial) challenges and (3) determinants for success in regional dementia care networks; (4) to support sustainable implementation of successful structures (translation).

Methods: We conducted a multicenter, interdisciplinary evaluation of Dementia Networks in Germany (DemNet-D). Totally 13 DCN and 560 dyads of PWD and their caregivers participated in this study. Qualitative analyses were based on standardized interviews with representatives of the DCN, quantitative analyses on primary data obtained in face-to-face interviews with PWD and their caregivers.

Results: (1) Patients in DCN more often received treatment by general practitioners (93% vs. 90%) and neurologist/ psychiatrists (74% vs 31%) and were treated more often with anti-dementia drugs (52% vs. 30%) compared to primary and nursing care settings. Furthermore, these patients received more often non-pharmacological treatments, like physiotherapy (24% vs. 6%) and occupational therapy (15% vs. 6%). (2) Predictors for financial sustainability were a secure funding of more than 50.000$/year for human resource coordinating the DCN, a mix of different financing sources, and investments of the municipality. (3) The scientific evidence concerning “building up”, “financing”, “practicing” and “evaluating” DCN were transferred into practically relevant information on an online-information-portal (https://demenznetzwerke.de/) and a toolbox of more than 135 practically relevant documents and instruments obtained from different German DCN. Since the launch of this website in September 2015, more than 8,850 downloads of tools are recorded, meaning that there were on average 600 downloads of tools every month.

Scientific outlook: Results of the DemNet-D study had a policy impact on German legislation: nursing health care insurances now can support DCN with an annual funding of up to 20.000$ per DCN. DCN improve treatment and care in dementia and the funding as well as the online-based toolbox are important steps towards the sustainability of DCN.