Dementia Care Program Reduces Hospitalizations, Improves Treatment Adherence

A pilot program in South Korea aimed at providing specialized dementia care physicians has shown promising results, significantly reducing hospitalization rates among mild dementia patients. According to a report by the Health Insurance Review & Assessment Service (HIRA), mild dementia patients who received at least three consultations and ongoing management from a dementia care physician saw their hospitalization rate drop from 2.0% to 0.7%.

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The hospitalization rate for mild dementia patients who received three or more consultations and management from a dementia care physician decreased by 1.3 percentage points, from 2.0% to 0.7%.

In contrast, patients not participating in the program experienced an increase in hospitalization rates, rising from 0.7% to 2.3%. This created a 2.9 percentage point gap in hospitalization rates between participants and non-participants. The study compared 1,457 dementia patients enrolled in the pilot program with a control group of 5,776 similar patients who were not part of the initiative. The program supports outpatients diagnosed with dementia to receive continuous management for chronic conditions like hypertension and diabetes from specialists registered with the Ministry of Health and Welfare, within their local communities.

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The gap in hospitalization rates widened by 2.9 percentage points compared to non-participating patients.

Participants in the program also demonstrated higher treatment continuity and medication adherence. The rate of continuous treatment at a single hospital increased by 7.1 percentage points, from 88.5% before the program to 95.5% afterward. Medication adherence was also 2.6 percentage points higher compared to the control group. Furthermore, patients under the care of a dementia physician showed slower progression of clinical symptoms and daily functional decline. The worsening of dementia severity scores was 0.25 points less than in the control group, and behavioral and psychological symptoms, such as verbal aggression and wandering, decreased from an average of 4.4 per patient to 2.6.

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The rate of continuous treatment at a single hospital increased by 7.1 percentage points, from 88.5% to 95.5%.

Despite these positive outcomes, the program faces challenges. Only 24.6% of the 252 medical institutions that applied to participate actually provided services. The uptake for integrated management of chronic diseases like hypertension and diabetes was low at 5.3%, and the utilization of home-visit services for patients with mobility issues was only 1.4%. The report recommends establishing detailed service models tailored to patient conditions and severity, strengthening comprehensive dementia care through linkage with dementia care physicians, and enhancing community resource coordination.

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Behavioral and psychological symptoms decreased from an average of 4.4 per patient to 2.6.