Intermediate care in caring for people living with dementia: analysis of general practitioners’ assessment of intermediate care in Latvia as part of a multinational European study

Intermediate care is often defined as healthcare occurring somewhere between traditional primary (community) and secondary (hospital) care settings. A survey performed by the European General Practice Research Network (EGPRN) found great variation in the use of intermediate care for persons with neurocognitive disorders across Europe. This study aims at investigating intermediate care services for people with neurocognitive disorders. No previous studies on intermediate care from the general practitioners’ (GP’s) point of view have been carried out in Latvia. This study is a part of a European wide study in collaboration with the EGPRN. A key informant survey that used a semi-structured 14-item questionnaire, designed by the EGPRN, was translated into Latvian and completed by 20 Latvian general practitioners from June-September 2020. We aimed to examine how general practitioners perceive the advantages and disadvantages of intermediate care, availability of services and quality of care. A mixed method approach was applied in analysing the questionnaire where the open-ended questions followed a “Sequential Explanatory Design”. In Latvia, the most accessible types of intermediate care include integrated home services, nursing homes and residential homes. The availability of services between regions was perceived by 70% of respondents as being non-homogeneous. Intermediate care was perceived by all respondents as either improving the quality of patient care, the quality of life for care givers, or both. The quality of intermediate care was perceived by 80% as low. Access to intermediate care was limited by lack of financial support and difficult bureaucratic procedures. Responses of Latvian GP’s imply that limited finances affect the availability, accessibility, and quality of intermediate services for patients in Latvia. Latvian GP’s perception is that intermediate care improves the quality of care for patients with dementia, and the quality of life for their care givers.