Abstract
Objectives To identify which clinical specialties are most central for care of people with dementia in the community and long-term care (LTC) settings. Design Cross-sectional analysis. Participants Fee-for-service Medicare beneficiaries aged ≥65 years with dementia. Measurements Specialty, categorized into primary care (internal or family medicine, geriatrics, or nurse practitioners [NPs]) versus other specialties, of the predominant provider of care (PPC) for each patient, defined by providing the most ambulatory visits. Results Among 2,598,719 beneficiaries with dementia, 74% lived in the community and 80% had a PPC in primary care. In LTC, 91% had primary care as their PPC compared with 77% in the community (P < .001). Cardiology and neurology were the most frequent specialties. NPs were PPCs for 19% of dementia patients in LTC versus 7% in the community (P < .001). Conclusion It is unknown whether specialists are aware of their central role for many dementia patients’ care needs. In LTC, NPs play the lead role as PPCs.
Original language | English (US) |
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Pages (from-to) | 802-806 |
Number of pages | 5 |
Journal | Journal of the American Medical Directors Association |
Volume | 17 |
Issue number | 9 |
DOIs | |
State | Published - Sep 1 2016 |
Keywords
- Medicare
- Predominant provider
- dementia
- long-term care
- primary care
- specialist
ASJC Scopus subject areas
- General Nursing
- Health Policy
- Geriatrics and Gerontology