대한노인정신의학회

Objective: Dementia-specific nursing facilities have been established in South Korea to provide specialized services for patients with dementia, yet their effectiveness has not been evaluated. This study assessed the utility of these facilities by analyzing mortality and morbidity.

Methods: Data from the National Health Insurance Service and Long-Term Care Insurance databases were analyzed. Participants were classified into the dementia-specific facility group and the general facility group. To balance baseline characteristics, 1:3 propensity score matching was performed, yielding 835 patients in the dementia-specific group and 2,505 in the general group. Mortality and morbidity, including fractures, pneumonia, pressure ulcers, and cerebrovascular diseases, were compared. Logistic regression was used to evaluate adjusted probabilities after controlling for multiple variables.

Results: The dementia-specific facility group showed lower mortality and reduced morbidity of pneumonia and pressure ulcers compared with the general facility group. These associations remained significant after adjustment for variables such as activities of daily living.

Conclusion: Lower mortality and morbidity in dementia-specific facilities may be related to communal living spaces and dementia-tailored programs that reduce social isolation and enhance physical activity. Given the possibility of residual confounding, further studies with rigorous designs are needed.

Dementia; Mortality; Pneumonia; Pressure ulcers; National Health Insurance Service; Long Term Care Insurance.