Artikel
Prevalence of low-value care and its associations with patient-centered outcomes in dementia
Suche in Medline nach
Autoren
-
Moritz Platen
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
-
Anika Rädke
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
-
Diana Wucherer
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Interventionelle Versorgungsforschung, Greifswald, Deutschland
-
René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Interventionelle Versorgungsforschung, Greifswald, Deutschland; Universitätsmedizin Greifswald, Institut für Community Medicine, Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
-
Wiebke Mohr
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
-
Franka Mühlichen
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
-
Annelie Scharf
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
-
Wolfgang Hoffmann
- Universitätsmedizin Greifswald, Institut für Community Medicine, Versorgungsepidemiologie und Community Health, Greifswald, Deutschland
-
Bernhard Michalowsky
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Rostock/Greifswald, Translationale Versorgungsforschung, Greifswald, Deutschland
| Veröffentlicht: | 27. September 2021 |
|---|
Gliederung
Text
Background and status of (inter)national research: The rapidly increasing prevalence and associated costs of dementia are likewise global problems. While most of these costs are caused by demographic changes, new treatment possibilities, and increasing demand, estimates of the total annual cost of waste are approximately 25% of total healthcare spending. This includes, for example, overtreatment of patients or so-called low-value care (LvC), defined as care unlikely to provide a benefit to the patient or have the potential to cause harm.
Question and objective: This study aims to determine the associations between LvC and patient-centered outcomes of people living with dementia (PwD).
Method or hypothesis: The analysis was based on the baseline data of the DelpHi-MV trial and included 516 PwD. The association of LvC with health-related quality of life (HRQoL) and hospitalization was assessed using multiple regression models.
Results: LvC was highly present among community-dwelling PwD. Approximately one-third (31%) of participants received at least one LvC treatment. PwD who received LvC treatments had a lower HRQoL (b=-0.08; 95% CI 0.14 – 0.02) and were more likely to be hospitalized (OR=2.11; 95% CI 1.30 – 3.41). In contrast, various recommended alternative treatments were associated with both positive and negative changes in HRQoL.
Discussion: Regarding the predicted prevalence of people with dementia, reducing and replacing LvC could improve the HRQoL and satisfy the needs of prospective people living with dementia. A reduction could also decrease hospitalization risks and have beneficial effects on the increasing health expenditures.
Practical implications: To increase the value of and relieve physicians in care simultaneously, further research is needed about dementia-related frameworks that identify and reduce low-value and cost-driving treatments.
Appeal for practice (science and/or care) in one sentence: Improve clinician awareness and empower patients.
