동네 치매주치의한테 진료받았더니…입원율 줄고 치료지속성 늘었다

A neighborhood dementia care pilot program has shown that participants receive fewer hospitalizations and increased treatment continuity. According to a report published by the Health Insurance Review and Assessment Service on December 13, dementia patients receiving three or more consultations and management from the dementia care pilot program had a 1.3 percentage point lower hospitalization rate after the program compared to 2.0% before the program.

In contrast, patients who didn't participate saw their hospitalization rate rise from 0.7% to 2.3%, a 1.6 percentage point increase. This results in a 2.9 percentage point gap between the two groups. The study compared 1,457 dementia patients who participated in the pilot program and 5,776 similar control patients. The pilot program provides support for dementia patients from their homes, including ongoing management of chronic conditions such as hypertension and diabetes.

As of last December, 5,964 registered dementia patients received services from 62 participating healthcare institutions and 77 dementia caregivers. The proportion of patients continuing to be treated by the same doctor, known as treatment concentration, increased from 88.5% to 95.5% after participating in the program, a 7.1 percentage point rise.

The medication adherence rate, or the percentage of patients who take their prescribed medications as directed, also increased by 2.6 percentage points in the program group compared to the control group. Additionally, dementia patients showed improvements in both clinical symptoms and daily living functions. They also experienced a 0.25-point decrease in dementia severity scores and a 1.8-point reduction in behavioral symptoms such as agitation.

The rate of patients experiencing depression decreased by 4.98 points. On the other hand, the shortage of service providers for the pilot program, lack of integrated management participation, and low rates of visiting consultations for inconvenient patients were also noted. Out of 252 healthcare institutions that applied for the program, only 24.6% actually provided services.

The participation rate for integrated management of chronic conditions like hypertension and diabetes was 5.3%, while the rate of visiting consultations for patients with inconvenient schedules was only 1.4%. The report states that "detailed service models for dementia patients based on their condition and severity need to be established, and the primary functions of first-contact care and continuity in day-to-day care should be enhanced through collaboration with primary care physicians, to comprehensively manage the health of dementia patients and integrate community resources."