TY - JOUR
T1 - Determinants of Care Costs of Patients With Dementia or Cognitive Impairment
AU - Handels, Ron L. H.
AU - Wolfs, Claire A. G.
AU - Aalten, Pauline
AU - Verhey, Frans R. J.
AU - Severens, Johan L.
PY - 2013
Y1 - 2013
N2 - Introduction: Dementia causes a high burden on patients, caregivers, and societies. Decision analytic models to support allocation of resources are often developed making use of cost-of-illness (COI) studies. However, current COI study estimates are highly variable due to care setting and methodological issues. We aim to explore variables explaining the variation of (formal and informal) health care costs of cognitive disorders, using a broad spectrum of variables, including patient, caregiver, and social context variables. Methods: A bottom-up COI study design was used in which a societal viewpoint and a validated method to measure and value informal care was applied. Data were analyzed using univariate, multivariate, and forward regression analyses. Results: The average 1-year health care sector costs were (sic)26,140 ($34,505 or 17,775) pound and (sic)11,931 ($15,749 or 8113) pound for patient and family. The analyses indicated that cognitive functioning, caregiver burden, patient sex, and instrumental activities of daily living were significantly associated with care costs independently. Conclusions: Cognitive functioning and instrumental activities of daily living are important variables to include in health care decision models. We recommend also including caregiver burden and patient sex in decision models for health policy decision makers to fully reflect the heterogeneity of the disease progression of cognitive disorders.
AB - Introduction: Dementia causes a high burden on patients, caregivers, and societies. Decision analytic models to support allocation of resources are often developed making use of cost-of-illness (COI) studies. However, current COI study estimates are highly variable due to care setting and methodological issues. We aim to explore variables explaining the variation of (formal and informal) health care costs of cognitive disorders, using a broad spectrum of variables, including patient, caregiver, and social context variables. Methods: A bottom-up COI study design was used in which a societal viewpoint and a validated method to measure and value informal care was applied. Data were analyzed using univariate, multivariate, and forward regression analyses. Results: The average 1-year health care sector costs were (sic)26,140 ($34,505 or 17,775) pound and (sic)11,931 ($15,749 or 8113) pound for patient and family. The analyses indicated that cognitive functioning, caregiver burden, patient sex, and instrumental activities of daily living were significantly associated with care costs independently. Conclusions: Cognitive functioning and instrumental activities of daily living are important variables to include in health care decision models. We recommend also including caregiver burden and patient sex in decision models for health policy decision makers to fully reflect the heterogeneity of the disease progression of cognitive disorders.
KW - dementia
KW - Alzheimer disease
KW - caregiver burden
KW - decision analytic modeling
KW - economics
KW - cost-of-illness study
U2 - 10.1097/WAD.0b013e318242da1d
DO - 10.1097/WAD.0b013e318242da1d
M3 - Article
C2 - 22214890
SN - 0893-0341
VL - 27
SP - 30
EP - 36
JO - Alzheimer Disease & Associated Disorders
JF - Alzheimer Disease & Associated Disorders
IS - 1
ER -