Five-Year Community Management Rate for Dementia Patients: A Proposed Indicator for Dementia Policies

Abstract

Background and Purpose There is no specific indicator for monitoring dementia management. We propose an auxiliary indicator called the community management rate, defined as the proportion of dementia patients who receive informal care from close caregivers or themselves within their community population. The 5-year community management rate is the percentage of dementia patients who are receiving community management at 5 years after they were diagnosed. The aim of this study was to identify how the community management rate has changed over time and how the 5-year community management rate differs according to age, sex, income, residence area, and comorbidities. Methods We analyzed customized research database of the Korean National Health Insurance Services from 2003 to 2018. The 5-year community management rate was calculated annually with newly diagnosed dementia patients, and compared among subgroups according to age, sex, income, residence area, and comorbidities. Results This study analyzed 549,297 patients. Among those newly diagnosed with dementia in 2003, the mean duration of community management during the 15-year follow-up was 5.98 years. The community management rate decreased rapidly from 2003 to 2006, after which it increased. A low 5-year community management rate was associated with older age, higher comorbidity burden, nonmetropolitan residence, and low income. Conclusions The community management rate seems to reflect diverse patient factors. Efforts are needed to reduce the comorbidity burden and differences in the 5-year community management rate according to residence area and income. This study indicates the need for further investigations into the use of this indicator to monitor the management of dementia patients.

Annual Incidence of Dementia from 2003 to 2018 in Metropolitan Seoul, Korea: A Population-Based Study

“…NDP-3 tried to enhance community-based prevention and management of dementia, care, and treatment for dementia patients, reduce care burden for caregivers, and support through research, statistics, and technology. The main objectives of NDP-3 were the expansion of the dementia partner program, initiation of dementia-friendly communities, and intensive management for dementia high-risk groups [8,17]. These policies were designed to identify dementia patients who were not receiving medical care.…”

“…In addition, national dementia plans (NDPs) were released in 2018 and conducted with DSCs. The purposes of DSCs and NDPs are to find dementia patients in earlier stages with dementia screening programs, to prevent dementia by managing risk factors, to improve awareness of dementia, and to reduce the diverse burdens on dementia patients and their caregivers [8]. As a result of the diverse policies, including the dementia screening program, we expected that the incidence of dementia would increase rapidly but temporarily.…”

Comparing the Characteristics of Patients With Newly Diagnosed Dementia Before and After 2008 in Seoul, South Korea: A Population-Based Study

“…The International Classification of Diseases (ICD-10) version of the Charlson Comorbidity Index (CCI) was used. 3 4 The patients were divided into groups according to age (six groups: 60–64, 65–69, 70–74, 75–79, 80–84, and ≥85 years old), sex, CCI (four groups: 0, 1, 2, and ≥3), income (quintiles), and dementia type (unspecified dementia [F03], Alzheimer’s disease dementia [F00, G30], vascular dementia [F01], and other [F02, G31.00–04, G31.82]). Patients with dementia who were first diagnosed during 2005–2007 or 2009–2011 were compared using t -test and chi-square test.…”

“…5 These plans included a mass dementia screening program, education to encourage self-checkups for dementia, financial medical support for patients with dementia and their caregivers, infrastructure expansion, and public awareness campaigns. 4 6 DSCs, which were responsible for implementing the NDPs, were introduced in all districts of Seoul during 2007–2009. These efforts have reduced the socioeconomic barriers experienced by patients with dementia and facilitated dementia diagnoses.…”

“…Implementing mass screening programs makes it easier to identify patients in the early stages of dementia. 4 7 The reason for the increased incidence of unspecified dementia was not clear, but a possible reason is identifying dementia at its early stages without sufficient pathological studies. Further studies are needed to clarify this.…”