Patients with dementia syndrome in public and private services in southern Brazil

Dementia is characterized by deficits in more than one cognitive domain, affecting language, praxis, gnosis, memory or executive functions. Despite the essential economic growth observed in many developing countries, especially over the last century, huge differences remain in health care, whether among nations themselves or across different regions of the same country. Objective The aim of this study was to assess the management and main features of dementia, comparing public (PUBL) and private (PRIV) reference services. Methods We performed a retrospective analysis of medical records of subjects with dementia. Sociocultural data, mean follow-up time in the service, Mini-mental State Examination (MMSE) scores at admission, main diagnosis of dementia, family history of dementia, comorbidities, imaging methods and treatment were assessed. Results the time elapsed before admission in the service of the PUBL group (2.08±2.06 years) was higher than for the PRIV group (1.24±2.55 years) (p=0.0356); the MMSE score at admission in the PUBL group (15.05±8.16 years) was lower than in the PRIV group (18.95±6.69 years) (p=0.016); the PUBL group showed lower treatment coverage with cholinesterase inhibitors (52.94%) than the PRIV group (84.93%) (p=0.0001). Conclusion Patients seeking the public health service have less access to medical care, reaching the system at more advanced stages of disease. The public service also offered lower pharmacological coverage.