Differences in healthcare service utilization between older adults with and without dementia: a cross-sectional study in Shandong, China

Aim Dementia is characterized by a decline in cognitive functioning and is the main cause of disability, mortality, and care dependence among older adults. This study compared healthcare utilization in older adults with and without dementia and explored factors influencing service use in the former. Subject and methods A total of 8847 seniors (≥ 60 years) were chosen from the Health Service Survey of Shandong Province conducted in 2018. The chi-square test was used for baseline characteristics and healthcare utilization for older adults with and without dementia. Multivariate logistic regression analysed service utilization factors. Results Of the respondents, 261 (3.0%) had dementia. The proportions of respondents who used outpatient care and inpatient care were 40.6% and 76.9%, respectively. The rates of outpatient and inpatient care use among seniors with dementia were slightly higher than those among seniors without dementia (44.8% vs 40.5% and 80.8% vs 76.7%, respectively). Older adults with dementia who were married and had experienced non-communicable diseases within the past 6 months were less likely to use outpatient care. No factors associated with the utilization of inpatient care were found. Conclusion Health publicity and a combination of community care and medical assistance targeting older adults with dementia is essential to increase healthcare service utilization.