Avoidable Hospitalizations in Persons with Dementia: a Population-Wide Descriptive Study (2000–2015)

Abstract

Background Whether avoidable hospitalizations in community-dwelling persons with dementia have decreased during primary care reforms is unknown. Methods We described the prevalence and trends in avoidable hos­pitalizations in population-based repeated yearly cohorts of 192,144 community-dwelling persons with incident dementia (Quebec, 2000–2015) in the context of a province-wide pri­mary care reform, using the provincial health administrative database. Results Trends in both types of Ambulatory Care Sensitive Condition (ACSC) hospitalization (general and older population) and 30-day readmission rates remained constant with average rates per 100 person-years: 20.5 (19.9–21.1), 31.7 (31.0–32.4), 20.6 (20.1–21.2), respectively. Rates of delayed hospital discharge (i.e., alternate level of care (ALC) hospitalizations) decreased from 23.8 (21.1–26.9) to 17.9 (16.1–20.1) (relative change -24.6%). Conclusions These figures shed light on the importance of the phenomenon, its lack of improvement for most outcomes over the years, and the need to develop evidence-based policies to prevent avoidable hospitalizations in this vulnerable population.