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Quality of care provided to people with dementia: utilisation and quality of the annual dementia review in general practice
- Source :
- British Journal of General Practice. 62:e91-e98
- Publication Year :
- 2012
- Publisher :
- Royal College of General Practitioners, 2012.
-
Abstract
- Background Primary care services are often the main healthcare service for people with dementia; as such, good-quality care at this level is important. Aim To measure the quality of care provided to people with dementia in general practice using routinely collected data, and to explore associated patient and practice factors. Design and setting Observational, cross-sectional review of medical records from general practices ( n = 52) in five primary care trusts. Method A total of 994 people with dementia were identified from dementia registers. An unweighted quality-of-care score was constructed using information collected in the annual dementia review, together with pharmacological management of cognitive and non-cognitive symptoms. Multilevel modelling was carried out to identify factors associated with quality-of-care scores. Results In total, 599 out of 745 (80%) patients with dementia had received an annual dementia review; however, a social care review or discussion with carers was evident in just 305 (51%) and 367 (61%) of those 599 cases, respectively. Despite high prevalence of vascular disease, over a quarter ( n = 259, 26%) of all patients with dementia were prescribed antipsychotics; only 57% ( n = 148) of these had undergone medication review in the previous 6 months. Those with vascular dementia who were registered with single-handed practices received poorer quality of care than those registered with practices that had more than one GP. Conclusion Although the number of people with dementia with a record of an annual dementia review is high, the quality of these reviews is suboptimal. The quality score developed in this study could be used as one source of data to identify weaknesses in practice activity that need to be corrected, and so would be of value to commissioners and regulators, as well as practices themselves.
- Subjects :
- Male
medicine.medical_specialty
Cross-sectional study
General Practice
law.invention
Drug Utilization Review
Randomized controlled trial
law
mental disorders
Health care
medicine
Humans
Dementia
Psychiatry
Vascular dementia
Reimbursement, Incentive
Aged
Quality of Health Care
Aged, 80 and over
Depressive Disorder
business.industry
Research
Medical record
medicine.disease
Cross-Sectional Studies
England
Family medicine
Female
Observational study
Family Practice
business
Subjects
Details
- ISSN :
- 14785242 and 09601643
- Volume :
- 62
- Database :
- OpenAIRE
- Journal :
- British Journal of General Practice
- Accession number :
- edsair.doi.dedup.....1b615e30fbf0c03ab9c9990a036e2003