Understanding Factors that Influence Why People with Dementia Make Transitions from the Community to Acute Hospital Care Settings in the Last Months of Life
Project U-Care
This retrospective cohort study uses routine data to understand why people with dementia move between healthcare settings (termed a ‘transition’) in the months preceding their deaths.
Aims
To determine the relative individual, illness-related, and environmental factors associated with burdensome transitions for people with dementia in their last year of life, to inform effective public health policies to improve care towards the end of life for this growing population.
Methods
We will use data that has already been collected as part of hospital and administrative systems to explore the factors associated with burdensome transitions for people with dementia in the last months of life. These factors will be classified according to whether they are related to the individual themselves (e.g. age, ethnicity), to the illness (e.g. mental function, physical function), or to the environment (e.g. local services available). We will use statistical techniques to understand the relative importance of these factors and build a model of how they interact. The results will be used to inform health policies, in order to reduce burdensome transitions for people with dementia close to the end of life.
Publications
Sleeman KE, Perera G, Stewart R, Higginson IJ. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. Alzheimers Dement. 2018 Jan;14(1):20-27 https://pubmed.ncbi.nlm.nih.gov/28838779/
Leniz J, Higginson IJ, Stewart R, Sleeman KE. Understanding which people with dementia are at risk of inappropriate care and avoidable transitions to hospital near the end-of-life: a retrospective cohort study. Age Ageing. 2019 Sep 1;48(5):672-679. https://pubmed.ncbi.nlm.nih.gov/31135024/
Publications
Sleeman KE, Perera G, Stewart R, Higginson IJ. Predictors of emergency department attendance by people with dementia in their last year of life: Retrospective cohort study using linked clinical and administrative data. Alzheimers Dement. 2018 Jan;14(1):20-27 https://pubmed.ncbi.nlm.nih.gov/28838779/
Leniz J, Higginson IJ, Stewart R, Sleeman KE. Understanding which people with dementia are at risk of inappropriate care and avoidable transitions to hospital near the end-of-life: a retrospective cohort study. Age Ageing. 2019 Sep 1;48(5):672-679. https://pubmed.ncbi.nlm.nih.gov/31135024/
Principal Investigator
Katherine Sleeman
Laing Galazka Chair in Palliative Care, Honorary Consultant in Palliative Medicine
Investigators
Irene Higginson
Executive Dean, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care
Robert Stewart
Professor of Psychiatric Epidemiology & Clinical Informatics
Deok Hee Yi
Health Economist
Affiliations
Funding
Funding Body: National Institute for Health Research
Amount: £794,133.00
Period: March 2016 - August 2021