The World Alzheimer Report 2016, Improving healthcare for people living with dementia: Coverage, quality and costs now and in the future, reviews research evidence on the elements of healthcare for people with dementia and using economic modelling, suggests how it should be improved and made more efficient.
The report argues that current dementia healthcare services are over-specialised and that a rebalancing is required with a more prominent role for primary and community care. This would increase capacity, limit the increased costs associated with scaling up coverage of care, and, coupled with the introduction of care pathways and case management, improve the coordination and integration of care.
Some key findings from the report include:
- Current specialist models of dementia care are unlikely to be able to scale up to provide sufficient coverage for the growing number of people affected by dementia, particularly in in low- and middle-income countries
- More must be done to help people with dementia to optimise their physical health, maintain their nutrition and hydration, and reduce their risks of falls, infection and delirium
- The needs of people with dementia, and their carers, change over time. Care systems must be responsive to this, maintaining regular contact, monitoring and reviewing care plans, and providing support and interventions to meet needs when they arise
- In hospital, specialist dementia nurses, dementia care units, and specialist liaison services can help to improve the quality of care, but there is little evidence that they help shorten admissions
Modelling of the costs of care pathways was carried out in Canada, China, Indonesia, Mexico, South Africa, South Korea and Switzerland, to estimate the costs of dementia healthcare under different assumptions regarding delivery systems.