Projects terminated

Claims-data based analysis of diabetes care for people with dementia
Investigators:Dr. L. Schwarzkopf, Dr. M. Schunk, Prof. Dr. R. Holle
Funded by:German Alzheimer’s Society
(Deutsche Alzheimer Gesellschaft e.V.)
Duration:26 months
Description:Type 2 Diabetes is a common disease in older age and also affects many people with dementia. However, little is known about the quality of diabetes care for people with dementia.

This project will analyze processes and outcomes of diabetes care for people with dementia in community-based and institutional care settings, using claims data of a large regional Statutory Health and Long-Term Care Insurance fund.

To test for differences, diabetes care in people with and without dementia are compared. Furthermore, the impact of diabetes is analyzed by comparing people suffering from dementia alone or in combination with diabetes.
Objectives:This study aims to find out whether people with dementia receive diabetes care according to evidence based standards and whether the quality of diabetes care differs between people with and without dementia.

Furthermore, this project aims to provide evidence on the impact of diabetes on the care needs of people with dementia, also in view of the financial burden incurred for the health and long term care system.

All of the above research questions consider gender-specific aspects.
Methods:The claims-based data set, originally compiled for another study, includes 9.147 persons with dementia as well as 29.741 age and sex matched controls covered by the AOK Statutory Health Insurance fund.

Out of this set four groups have been extracted:
• Group 1: People with dementia and with diabetes
• Group 2: People without dementia and with diabetes
• Group 3: People with dementia and without diabetes
• Group 4: People without dementia and without diabetes.

The selection of people with diabetes was carried out using a definition of Hauner et al.

Processes of diabetes care were compared between group 1 and group 2, using information on medication and the number and frequency of check-up examinations. Outcomes of diabetes care were compared using information on number and frequency of diabetes-related complications and related medical procedures. The diabetes associated expenditures for the SHI system were investigated within an excess cost analyses which used group 3 respectively group 4 as point of reference.

Within additional analyses type and level of LTC-insurance benefits were compared between group 1 and group 3 and so were LTCI expenditures.

Moreover community-living and institutionalized individuals with dementia and diabetes (all group 1) were contrasted regarding processes of diabetes care and corresponding SHI expenditures taking in account different care needs in both settings.

Study results have been presented at the 2014 biennial conference of the German Alzheimer’s Society. Publication of the final results is expected in 2015.