Provision of dementia-related services in Canada: a comparative study

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dc.contributor.authorTam-Tham, Helen
dc.contributor.authorNettel-Aguirre, Alberto
dc.contributor.authorSilvius, James
dc.contributor.authorDalziel, William
dc.contributor.authorGarcia, Linda
dc.contributor.authorMolnar, Frank
dc.contributor.authorDrummond, Neil
dc.date.accessioned2016-05-24T22:58:53Z
dc.date.available2016-05-24T22:58:53Z
dc.date.issued2016
dc.description.abstractBackground Dementia is common, particularly among older adults, and is one of the major causes of dependency later in life. We sought to provide an overview and comparison of key services related to dementia care as the disease progresses in three large Canadian healthcare centres. Methods We identified family physicians, geriatric specialists, and dementia case managers from three major population centres in Canada with universal healthcare coverage. Using a standardized longitudinal dementia case vignette, participants were interviewed on services they would provide at each stage of the disease. We used principles of content analysis to generate codes and identify themes; appropriate time frames from the vignette fitting the necessary provision of services were derived from the Canadian consensus statement and determined in consultation with clinical experts. Proportions of participants that identified dementia-related care services were analyzed at each time point of the vignette using chi-square tests. Results Thirty-four healthcare providers from Calgary (Alberta), Edmonton (Alberta), and Ottawa (Ontario) participated. Review of our data identified seven overarching themes of dementia-related care services. Services provided in the community setting include future planning and related services, educational and social support services, and home care and respite services. Although all providers consistently identified educational and social support services (e.g. the Alzheimer Society) within the appropriate time frame, the provision of other services was variable. The proportion of providers reporting potential access of future planning services was significantly different across the three sites (Calgary, 91.7 %; Edmonton; 58.3 %; and Ottawa, 30.0 %), pā€‰=ā€‰0.012. Also, the proportion of providers that identified day program services were significantly different across the three sites (Calgary, 100.0 %; Edmonton, 91.7 %; and Ottawa, 60.0 %), pā€‰=ā€‰0.023 according to a chi-square test. Conclusions We found important types of variability in service delivery among different regions in Canada for a typical patient with dementia and their family caregiver. Health systems can be calibrated by aligning services from different settings to appropriate time points in the vignette, which illustrates the dynamic course of service delivery and opportunities for improvement throughout the disease trajectory.en_US
dc.description.refereedYesen_US
dc.description.sponsorshipUniversity of Calgary Open Access Authors Funden_US
dc.identifier.citationTam-Tham, H., Nettel-Aguirre, A., Silvius, J., Dalziel, W., Garcia, L., Molnar, F., & Drummond, N. (2016). Provision of dementia-related services in Canada: a comparative study. BMC Health Services Research, 16(1), 1.en_US
dc.identifier.doi10.1186/s12913-016-1435-1
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/33828
dc.identifier.urihttp://hdl.handle.net/1880/51242
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.publisher.departmentCommunity Health Sciencesen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen_US
dc.publisher.urlhttp://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1435-1en_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectHealth services deliveryen_US
dc.subjectDementiaen_US
dc.subjectVignetteen_US
dc.subjectCanadaen_US
dc.titleProvision of dementia-related services in Canada: a comparative studyen_US
dc.typejournal article
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