TY - JOUR

T1 - Diagnostic evaluation of dementia in the secondary health care sector

AU - Phung, Thien Kieu Thi

AU - Andersen, Birgitte Bo

AU - Kessing, Lars Vedel

AU - Mortensen, Preben Bo

AU - Waldemar, Gunhild

AU - Phung, Thien Kieu Thi

AU - Andersen, Birgitte Bo

AU - Kessing, Lars Vedel

AU - Mortensen, Preben Bo

AU - Waldemar, Gunhild

N1 - Keywords: Aged; Alzheimer Disease; Cognition; Delivery of Health Care; Dementia; Denmark; Guidelines as Topic; Humans; Magnetic Resonance Imaging; Medical Records; Neuropsychological Tests; Reference Standards; Registries; Reproducibility of Results; Specialization; Tomography, X-Ray Computed

PY - 2009

Y1 - 2009

N2 - BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence to clinical guidelines concerning dementia work-up is inadequate in the secondary health care sector. Our findings call for improvement in the organization of clinical dementia care, for education of specialists and for changes in attitude towards making a diagnosis of dementia.

AB - BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence to clinical guidelines concerning dementia work-up is inadequate in the secondary health care sector. Our findings call for improvement in the organization of clinical dementia care, for education of specialists and for changes in attitude towards making a diagnosis of dementia.

U2 - 10.1159/000223664

DO - 10.1159/000223664

M3 - Journal article

C2 - 19506375

VL - 27

SP - 534

EP - 542

JO - Dementia and Geriatric Cognitive Disorders

JF - Dementia and Geriatric Cognitive Disorders

SN - 1420-8008

IS - 6

ER -