BACKGROUND Challenges of future dementia care include increasing shortage of qualified healthcare providers and decreasing potential of informal care by relatives. In order to meet those challenges, changes in dementia care are needed. These changes should be based on data of both care utilisation and care supply. The aim of this study was to provide insight into individual and regional characteristics that influence the utilisation of long-term care by people with dementia. METHODS The study was a retrospective cross-sectional analysis of claims-based data and other available data referring to one index year. All data were aggregated for small geographic districts. The study population comprised people with a dementia diagnosis, 65 years and older in Baden-Wuerttemberg and insured by the largest health insurer. Utilisation of nursing home care, informal care, and respite care was analysed using binary coded logistic multilevel analyses. RESULTS Seventy nine thousand three hundred forty-nine people with dementia were included in the analyses. Nursing home care was used by 20.4%, informal care by 30.6%, and respite care by 3.5% of people with dementia. Individual characteristics that influence care utilisation included age, sex and the level of care dependency. The utilisation of informal care (OR = 1.713) and respite care (OR = 2.036) was higher in rural districts than in city districts. Respite care supply had an effect on the utilisation of respite care (OR = 1.173). CONCLUSIONS The study found differences between districts in the utilisation of long-term care for dementia. These differences were largely explained by the composition of the population within the districts. An exception was the utilisation of respite care, which was higher in districts which have higher supply. Individual characteristics that influenced care utilisation are age, sex, level of care dependency and, with regard to informal care, comorbidity. Further research should be conducted on a small-area level, include further individual characteristics as well as other care and living forms.

中文翻译：

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对德国巴登-符腾堡州痴呆症患者的个人和区域特征对长期护理利用的影响进行基于数据的分析。

背景技术未来痴呆症护理的挑战包括合格医疗保健提供者的短缺和亲戚提供非正式护理的潜力的减少。为了应对这些挑战，需要改变痴呆症的护理。这些变化应基于护理利用和护理供应的数据。这项研究的目的是深入了解影响痴呆症患者长期护理利用的个体和区域特征。方法该研究是回顾性横断面分析，涉及基于索赔的数据以及其他参考一个索引年的可用数据。所有数据都是针对小型地理区域的。研究人群包括在巴登-符腾堡州患有痴呆症的人，年龄在65岁以上，并由最大的健康保险公司投保。利用养老院护理，非正式护理和暂托护理使用二进制编码的逻辑多级分析进行了分析。结果纳入分析的痴呆患者为79.49万人。在老年痴呆症患者中，有20.4％使用了疗养院护理，有30.6％使用了非正式护理，有3.5％的人使用了暂托护理。影响护理利用的个人特征包括年龄，性别和护理依赖程度。农村地区的非正式护理（OR = 1.713）和暂息护理（OR = 2.036）的利用率高于城市地区。暂托服务的供应对暂托服务的使用产生影响（OR = 1.173）。结论研究发现不同地区之间在痴呆症长期护理的利用上存在差异。这些差异在很大程度上是由地区内的人口构成所解释的。例外情况是使用暂息护理，这在供应量较高的地区较高。影响照护利用的个体特征是年龄，性别，照护依赖程度，以及就非正式照护而言，合并症。应在小范围内进行进一步的研究，包括进一步的个人特征以及其他护理和生活形式。