Intermediate care in caring for dementia, the point of view of General Practitioners: a key informant survey across Europe

Clarisse Dibao-Dina, Caroline Oger, Tony Foley, Péter Torzsa, Vanja Lazic, Sanda Kreitmayer Peštiæ, Limor Adler, Ana Kareli, Christian Mallen, Cindy Heaster, Gindrovel Dumitra, Donata Kurpas, Rita Viegas, Stéphanie Giezendanner, Rosario Falanga, Aristea Missiou, Jan De Lepeleire, Aisling Jennings, Ferdinando Petrazzuoli, Victoria Tkachenko

Keywords: intermediate care, dementia, primary care

Background:
Intermediate care is often defined as healthcare occurring somewhere between traditional primary (community) and secondary (hospital) care settings. High quality intermediate care is important in dementia and may prevent caregiver burnout. However, very little is known about the point of of intermediate care for persons with dementia in Europe. This study aims at describing the point of view of General Practitioners on intermediate care services for people with neuro cognitive disorders across Europe.

Research questions:
How are intermediate care services used in the care for people with neuro cognitive disorders across Europe?

Method:
Key informant survey was sent to GPs via a self-developed questionnaire with space for open ended comments. Convenience sampling technique was used to address variations due to regional opportunities and regulations within the same country. Descriptive analyses of all intermediate care facilities groups by countries were performed.

Results:
The questionnaire was sent to 17 European countries. 583 questionnaires were analysed. The responding physicians were 48 (+/- 11) years old on average and they had been in practice for an average of 18 (+/11) years. The types of intermediate care considered were: integrated at-home services, respite and relief services, day care centres and nursing homes. Their availability was considered very inhomogeneous by the majority of respondents. The main benefits cited were better medical care for the patient (78%), better quality of life for the caregiver (67%), prevention of the caregiver burden (73%) and a break for the caregiver (59%). They reported difficulties were: accessing these facilities due to limited financial support (76%) and cumbersome administrative procedures (67%).

Conclusions:
Intermediate care in Europe is diverse and heterogeneous. Major concerns of GPs are about the cost issues, the accessibility and the awareness of the existence of these facilities and the procedure to access them.

Points for discussion:
Possible selection bias?

Relevance in primary Care