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J Gen Intern Med. 1995 Apr;10(4):187-93.

The effect of diagnosing Alzheimer's disease on frequency of physician visits: a case-control study.

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1
Division of Geriatrics, University of Washington, Seattle 98195, USA.

Abstract

OBJECTIVE:

Two groups of elderly subjects were studied to see whether patterns of visits to physicians changed after one group received the diagnosis of Alzheimer's disease.

DESIGN:

Case-control study.

SETTING:

Health maintenance organization (HMO).

PATIENTS/PARTICIPANTS:

Two groups of ambulatory subjects (mean age 77 years) were enrolled from an HMO population for this case-control study: 120 cases had probable Alzheimer's disease diagnosed at enrollment, and another 120 cognitively intact controls with similar comorbidity were enrolled after being frequency-matched for age and gender. Exclusion criteria were nursing home admission and death during the study period.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Medical records were examined for a four-year period: two years prior to and two years following enrollment and diagnosis. Physician visits declined slightly after enrollment for the persons receiving the diagnosis of Alzheimer's disease [17.5/2 years prior vs 16.5/2 years after (NS)], whereas visits increased over time for the controls [13.7/2 vs 16.3/2 (p < 0.05)], hence the rates were similar after enrollment [16.5 vs 16.3 (NS)]. The proportion of subjects with fewer visits during the period after enrollment was higher among the cases than it was among the controls [54% vs 37%; odds ratio = 2.0 (95% confidence interval = 1.6, 3.1)]. Hospitalizations and emergency department use did not change significantly after enrollment.

CONCLUSIONS:

Physician visit frequency was high before, then decreased after, demented patients received their diagnosis, approaching the frequency in a control population without dementia. This phenomenon cannot be accounted for by nursing home placement, comorbidity, or mortality. Increased hospitalization and emergency department use did not ensue after diagnosis.

Comment in

PMID:
7790979
DOI:
10.1007/bf02600253
[Indexed for MEDLINE]

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