Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data
Open Access
- 21 August 2017
- journal article
- research article
- Published by Wiley in Alzheimer's & Dementia
- Vol. 14 (1), 20-27
- https://doi.org/10.1016/j.jalz.2017.06.2267
Abstract
Introduction: A fall in hospital deaths in dementia has been interpreted as indicating an improvement in end-of-life care. Whether other indicators of quality of end-of-life care, such as emergency department (ED) attendance, show a similar trend is unclear. Methods: Retrospective cohort study using electronic medical records from a large mental health care provider, linked to national mortality and hospital use data (2008-2013). Results: Of 4867 patients, 78.6% (3824) had at least one ED attendance during their last year of life (mean 2.13, standard deviation 2.34, range 0-54). ED attendance increased over the time period (incidence rate ratio 1.62, 95% confidence interval 1.46-1.80 for 2012-2013 compared with 2008-2009). Discussion: ED attendance in the last year of life for people with dementia is common and is increasing. Policy makers must pay attention to a broader range of indicators of poor end-of-life care alongside the place of death. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.Keywords
Funding Information
- National Institute for Health Research (CS‐2015‐15‐005)
- Academy of Medical Sciences (AMS‐SGCL10‐Sleeman)
- Medical Research Council
- British Heart Foundation
- Arthritis Research UK
- King’s College London
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