Health service use by persons diagnosed with dementia 12 months before their diagnosis

Abstract Background With longevity the number of persons with dementia is increasing and timely diagnosis is crucial to minimise the strain to the service system and to improve the quality of life of older persons. For the sustainability of the service system, timely and accurate diagnosis is crucial to ensure appropriate care for the persons to be diagnosed with dementia and to avoid inappropriate service use. The aim of the study is to analyse the service use patterns before the dementia diagnosis using comprehensive national health registers in Finland. Methods A retrospective study was conducted among persons aged 65 or older who received their dementia diagnosis in 2021 in Finland. Dementia was defined based on the diagnosis found in the Finnish Health Care Registers, or as the prescription or dispensing of anti-dementia drug in the Finnish Prescription Centre. The study excluded persons living in 24/7-residential care facilities, and those whose residence or personal identity number was not known. Health service use during 12 months before the diagnosis included outpatient and inpatient care in primary and secondary health care, and emergency service. Results In 2021, the number of diagnosed persons was 22,419. The incidence was highest in the age group of 75-84. Nearly all diagnosed persons had used health services during the 12 months before receiving diagnosis and the service use increased during the last 12 months before the diagnosis. Conclusions The service use tends to increase relatively before the diagnosis. This may signify that the diagnosis is received at a rather late stage of the disease, and the early signs of dementia may remain unnoticed and actual care needs untreated in the healthcare system.