Jue Hua Lau1, Edimansyah Abdin2, Anitha Jeyagurunathan2, Esmond Seow2, Li Ling Ng3, Janhavi Ajit Vaingankar2, Siow Ann Chong2, Mythily Subramaniam2. 1. Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore. Jue_Hua_Lau@imh.com.sg. 2. Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, Singapore. 3. Department of Rheumatology & Immunology, Singapore General Hospital, SingHealth, Singapore, Singapore.
Abstract
BACKGROUND: Caregivers of persons with dementia (PWD) face high caregiving burden, distress related to responsive behaviours, and psychiatric morbidity. The present paper examines how these are associated with healthcare utilization of the PWD in Singapore. METHODS: The data of 399 caregiver-PWD dyads were extracted from a national cross-sectional survey. PWD completed the Client Service Receipt Inventory, which provided information on their healthcare utilization (i.e. emergency service use, hospital admission, length of stay in hospital, and number of outpatient visits) within a frame of 3 months. The Zarit Burden Interview (ZBI), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Self Reporting Questionnaire (SRQ-20) were administered to caregivers. Information on severity of dementia, physical multimorbidity of the PWD, household composition, and caregivers' sociodemographic characteristics such as age, gender, and education were collected. Variables significantly associated with healthcare utilization in the univariate analyses were selected and included in the final regression models. Emergency service use and hospital admission were investigated using logistic regression analyses, whilst negative binomial models were utilized for length of stay in hospital and number of outpatient visits. RESULTS: After adjusting for significant correlates such as dementia severity and multimorbidity, only caregiver distress from responsive behaviours was positively associated with emergency room utilization, while caregiver burden was positively associated with length of hospital stay in the final regression model. Psychiatric morbidity was associated with healthcare utilization outcomes at the univariate level but did not reach statistical significance in final models. CONCLUSION: The study identifies caregiver variables associated with the healthcare utilization of PWD. Policy makers and healthcare professionals should provide interventions to ease burden and distress amongst caregivers of PWD.
BACKGROUND: Caregivers of persons with dementia (PWD) face high caregiving burden, distress related to responsive behaviours, and psychiatric morbidity. The present paper examines how these are associated with healthcare utilization of the PWD in Singapore. METHODS: The data of 399 caregiver-PWD dyads were extracted from a national cross-sectional survey. PWD completed the Client Service Receipt Inventory, which provided information on their healthcare utilization (i.e. emergency service use, hospital admission, length of stay in hospital, and number of outpatient visits) within a frame of 3 months. The Zarit Burden Interview (ZBI), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Self Reporting Questionnaire (SRQ-20) were administered to caregivers. Information on severity of dementia, physical multimorbidity of the PWD, household composition, and caregivers' sociodemographic characteristics such as age, gender, and education were collected. Variables significantly associated with healthcare utilization in the univariate analyses were selected and included in the final regression models. Emergency service use and hospital admission were investigated using logistic regression analyses, whilst negative binomial models were utilized for length of stay in hospital and number of outpatient visits. RESULTS: After adjusting for significant correlates such as dementia severity and multimorbidity, only caregiver distress from responsive behaviours was positively associated with emergency room utilization, while caregiver burden was positively associated with length of hospital stay in the final regression model. Psychiatric morbidity was associated with healthcare utilization outcomes at the univariate level but did not reach statistical significance in final models. CONCLUSION: The study identifies caregiver variables associated with the healthcare utilization of PWD. Policy makers and healthcare professionals should provide interventions to ease burden and distress amongst caregivers of PWD.
Authors: Thomas Lehnert; Dirk Heider; Hanna Leicht; Sven Heinrich; Sandro Corrieri; Melanie Luppa; Steffi Riedel-Heller; Hans-Helmut König Journal: Med Care Res Rev Date: 2011-08 Impact factor: 3.929
Authors: D I Kaufer; J L Cummings; P Ketchel; V Smith; A MacMillan; T Shelley; O L Lopez; S T DeKosky Journal: J Neuropsychiatry Clin Neurosci Date: 2000 Impact factor: 2.198
Authors: Elan L Guterman; I Elaine Allen; S Andrew Josephson; Jennifer J Merrilees; Sarah Dulaney; Winston Chiong; Kirby Lee; Stephen J Bonasera; Bruce L Miller; Katherine L Possin Journal: JAMA Neurol Date: 2019-10-01 Impact factor: 18.302
Authors: Ee Yuee Chan; Ling Ting Wu; Emmalene Joo Yong Ng; George Frederick Glass; Robyn Hwee Teng Tan Journal: BMC Health Serv Res Date: 2022-07-19 Impact factor: 2.908
Authors: Ting-Hway Wong; Timothy Xin Zhong Tan; Lynette Ma Loo; Wei Chong Chua; Philip Tsau Choong Iau; Arron Seng Hock Ang; Jerry Tiong Thye Goo; Kim Chai Chan; Hai V Nguyen; Nivedita V Nadkarni; David Bruce Matchar; Dennis Chuen Chai Seow; Yee Sien Ng; Angelique Chan; Stephanie Fook-Chong; Tjun Yip Tang; Marcus Eng Hock Ong; Rahul Malhotra Journal: PLoS One Date: 2022-10-10 Impact factor: 3.752