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Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data

Research output: Contribution to journalArticle

Original languageEnglish
JournalAlzheimers & Dementia
Early online date22 Aug 2017
DOIs
StateE-pub ahead of print - 22 Aug 2017

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King's Authors

Abstract

Introduction: A fall in hospital deaths in dementia has been interpreted as indicating an improvement in end-of-life care. Whether other indicators of quality of end-of-life care, such as emergency department (ED) attendance, show a similar trend is unclear.

Methods: Retrospective cohort study using electronic medical records from a large mental health care provider, linked to national mortality and hospital use data (2008–2013).

Results: Of 4867 patients, 78.6% (3824) had at least one ED attendance during their last year of life (mean 2.13, standard deviation 2.34, range 0–54). ED attendance increased over the time period (incidence rate ratio 1.62, 95% confidence interval 1.46–1.80 for 2012–2013 compared with 2008–2009).

Discussion: ED attendance in the last year of life for people with dementia is common and is increasing. Policy makers must pay attention to a broader range of indicators of poor end-of-life care alongside the place of death.

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