One-third of people living with dementia experience highly fragmented care without coordination — and those gaps in communication could be dangerous, a new study finds.
The report published Monday in the Journal of the American Geriatrics Society found the gaps in care aren’t just inconveniences, they can be dangerous.
Researchers evaluated claims data and a survey to evaluate how people perceived care coordination. If the patient with dementia was unable to respond to the survey a caregiver or proxy respondent completed it.
The team assessed repeat tests, drug interactions, emergency department visits, and hospital admissions. Data came from the NewYork Quality Care accountable care organization (ACO), which includes NewYork-Presbyterian Hospital, Weill Cornell Medicine (including the Weill Cornell Physician Organization) and Columbia University (including ColumbiaDoctors). Data was collected between 2022 and 2023. All participants were over 65 years old; the average age was 82.
A total of 97 people completed the surveys. Of those individuals, 90.7% had one or more ambulatory visits and one or more ambulatory providers, indicating a risk for gaps in care coordination.
Overall, 57% of respondents said there was a problem, or gap, when it came to coordination of care. Additionally, 18% of participants reported an adverse event that they believed was due to poor care coordination.
The patients with dementia had a median of six ambulatory visits and four providers in the previous 12 months. Among respondents, 89% felt the number of visits they had were needed, and 67% said the visits were agreed upon by them and their personal doctor. But 35% of respondents said they only somewhat received or did not receive the help they needed from their doctor’s office to manage their care among the various providers.
Authors of the report noted that it wasn’t clear if people living with dementia who have fragmented care (and their caregivers) see that there are gaps in communication among the providers involved.
