Neurologic and Psychiatric Health Care Services in Private Practices and Hospitals: Providing Care for Patients with Dementia

The sector boundaries between outpatient and inpatient care providers can cause breaks in the continuity of care. The German Society of Neurology (DGN), the professional associations of German Neurologists, Psychiatrists (BVDN, BDN and BVDP) and the National Association of Statutory Health Insurance Physicians (KBV) and the Central Research Institute of Ambulatory Health Care in the Federal Republic of Germany (ZI) therefore commissioned the IGES Institute to write up a report in order to have a strong analytic-empirical data basis for debate on the current highly controversial health policy. The care of patients with multiple sclerosis, dementia and schizophrenia were analyzed from sector-border perspective. Extensive patient-related data of the Barmer GEK health insurance is the basis of the present study. Here the results are presented on the care of patients with dementia (n= 130, 952 in 2010). Specialists in neurology and psychiatry were involved in the treatment of only about 42.3% of patients with dementia in 2010. Even less was the participation of specialists at initial diagnosis (25 %). The participation of specialists in the care of patients with dementia shows significant regional differences. Anti-dementia drugs are more frequently prescribed by medical specialists and more rarely by general practitioners. Dementia-related inpatient hospitalizations are rare (7 %), but vary markedly regionally. There is no correlation with the supply of beds and only a weak correlation with the number of outpatient practitioners and specialists in a region. The report underscores the need for a more cross-sectoral care planning.