Introduction: In this study we would like to give an overview about the presence of patients with dementia in the Hungarian health care system, because besides the cardiovascular diseases these are also important syndromes among the elderly. Alzheimer’s disease is the most common form of dementia and according to the global burden of disease statistics (GBD compare statistics) this (with other dementias) caused 3,8 % of the total deaths and 1,81 % of total DALY’s in Hungary. In the case of the population over 70 years of age it means 5,47 % of the total deaths and 5 % of total DALY’s.
Methods: This analysis shows the utilization of National Health Insurance Fund (NHIF) financed active, chronic and nursery care capacities during 2011-15 and the description of social care data from TeIR database during 2011-13. The patients have been selected from the NHIF database on the base of ICD classification (G3, F0-F3). The analysis is particularly focused on the characteristics of the patients over 65 years of age.
Results: This study presents that during five years there was a significant growth in the proportion of the total hospital days of the population over 65. The number of patients with dementia diagnosis is stabile; every year 17 thousand people appear in the hospitals. The patient number with dementia is 0,5 % from the total number of patients over 65 years of age and 0,9% from the total hospital days. In view of the age distribution of patients, the 80-84 age group covers the highest percentage (25%), but the proportion of the over 85-89 years of ages is also high (21%). The number of the female patients (12 thousand) is twice as high as male patients (5 thousand). The number of patients with Alzheimer’s disease is continuously growing; it was a 25 percent increasing from 2011 to 2015. The tendency is the same as in dementia; the 80-84 age group covers the highest percentage (27%) and the number of female patients (470) is almost double of the male patients (280). In the public-funded residential/nursing homes there were 10 753 residents (24%) with registered dementia from the total number of residents (45 519) in 2013.
Conclusions and discussions: According to the recent European Health Survey the lifestyles of the Hungarian people is not appropriate. The smoking, the heavy drinking or the insufficient degree of physical activity are the most important risk factors of dementia and many other diseases. The prevention and the early diagnosis of dementia are good for the patients and the care system, because the dementia usually means a loss of memory, reasoning, speech, and other cognitive functions, which put a significant burden on the informal carers and caregivers as well. This separated social and health care of people with dementia is not an optimal solution. The residential homes are suffering from the care burden of dementia despite of the increased normative fee of dementia. There are plenty of good practices around the world, which are worth to consider. The preservation of these patients’ dignity and the support in their everyday life should be the key elements of the dementia care, which requires strong cooperation between social and health care.
Limitations: The knowledge of the activities of the residential homes is very limited. The TEIR database is not complete and it does not contain some very important information about the cared residents. There is no information about the status of the patients, the care needs, the organized care programs in the social institutes. The main limitation of the examination of dementia is that, there is no methodologically unified collection of the people with dementia. The patients appear in social and health care databases, but some of them do not appear in the statistics. There is no connection between social and health care data, the common information system is missing, because of it is hard to monitoring of the status and needs of the patients.
Suggestions for future research: It would be very useful to know the real number of people with dementia, the real burden of dementia and to have information about the satisfaction of dementia care.