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Open Access Research article

Prevalence of neurological conditions across the continuum of care based on interRAI assessments

Oana Danila1*, John P Hirdes1, Colleen J Maxwell12, Ruth Ann Marrie3, Scott Patten456, Tamara Pringsheim4578 and Nathalie Jetté579

Author Affiliations

1 School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada

2 School of Pharmacy, University of Waterloo, Waterloo, Canada

3 Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Canada

4 Department of Psychiatry, University of Calgary, Calgary, Canada

5 Department of Community Health Sciences, University of Calgary

6 Mathison Centre for Research and Education in Mental Health, University of Calgary, Calgary, Canada

7 Department of Clinical Neurosciences, University of Calgary, Calgary, Canada

8 Department of Pediatrics, University of Calgary, Calgary, Canada

9 Hotchkiss Brain Institute and Institute for Public Health, University of Calgary, Calgary, Canada

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BMC Health Services Research 2014, 14:29  doi:10.1186/1472-6963-14-29

Published: 22 January 2014

Abstract

Background

Although multiple studies have estimated the prevalence of neurological conditions in the general Canadian population, limited research exists regarding the proportion affected with these conditions in non-acute health care settings in Canada. Data from standardized clinical assessments based on the interRAI suite of instruments were used to estimate the prevalence of eight neurological conditions across the continuum of care including Alzheimer’s disease, Parkinson’s disease, epilepsy, traumatic brain injury, multiple sclerosis, cerebral palsy, Huntington’s disease, and amyotrophic lateral sclerosis.

Methods

Cohorts of individuals receiving care in nursing homes (N=103,820), home care (N=91,021), complex continuing care (N=10,581), and psychiatric hospitals (N=23,119) in Canada were drawn based on their most recent interRAI assessment within each sector for a six-month period in 2010. These data were linked to the Discharge Abstract Database and National Ambulatory Care Reporting System data sets to develop five different case definition scenarios for estimating prevalence.

Results

The conditions with the highest estimated prevalences in these care settings in Canada were Alzheimer’s disease and related dementias, Parkinson’s disease, epilepsy, and traumatic brain injury. However, there were notable cross-sector differences in the prevalence of each condition, and regional variations. Prevalence estimates based on acute hospital administrative data alone were substantially lower for all conditions evaluated.

Conclusions

The proportion of persons with neurological conditions in non-acute health care settings in Canada is substantially higher than is generally reported for the general population. It is essential for these care settings to have the expertise and resources to respond effectively to the strengths, preferences, and needs of the growing population of persons with neurological conditions. The use of hospital or emergency department records alone is likely to substantially underestimate the true prevalence of neurological conditions across the continuum of care. However, interRAI assessment records provide a helpful source of information for obtaining these estimates in nursing home, home care, and mental health settings.

Keywords:
Nursing homes; Home care; Psychiatry; Epidemiology; interRAI