Abstract

Objectives

The Dementia Village model is emerging as an alternative to traditional nursing homes (NHs) for individuals with Alzheimer’s disease and related dementias. This study evaluates the impact of a French dementia village, Village Landais Alzheimer Henri Emmanuelli (VLAHE), on healthcare utilization among older adults with dementia.

Methods

This study uses an indirect comparative cohort design using data from 2 sources: a longitudinal observational study of VLAHE residents and an ad hoc cohort from the French nationwide claims database of NH residents. To improve comparability, the Matching-Adjusted Indirect Comparison method was applied. Weighted statistical tests and logistic regression models were used, yielding odds ratios with 95% confidence intervals. The outcomes analyzed include hospital admission rates, hospital stay duration, mortality, and place of death over a 2-year follow-up period between January 2021 and December 2022.

Results

VLAHE residents had fewer hospitalizations and shorter stays (10.5 vs 15.2 days, P = .0004) than comparable NH residents, particularly for acute care. Quarterly hospitalization rates were consistently lower (6.4% vs 11.1%), whereas no significant differences were found for psychiatric or rehabilitation stays. Fewer VLAHE residents died in hospital (9% vs 31%), suggesting improved end-of-life care (OR: 5.75, 95% CI [1.75-18.90]).

Conclusions

The VLAHE model may reduce hospitalizations and enhance end-of-life care through a structured, patient-centered approach. However, because of a potential residual clinical difference between groups and limitations of the matching method, further longitudinal research is needed to confirm its effectiveness.