Economic evaluation of an integrated diagnostic approach for psychogeriatric patients: results of a randomized controlled trial.
BACKGROUND
Because of the increasing number of elderly people with dementia, the costs of dementia and dementia care are expected to grow rapidly in the coming decades. Cost-effectiveness results are relevant for decision making about new strategies in dementia care.


OBJECTIVE
To evaluate the cost-effectiveness of an integrated multidisciplinary diagnostic facility for diagnosing dementia in ambulatory psychogeriatric patients.


METHODS
Randomized controlled trial with an economic evaluation component.


METHODS
The Maastricht Evaluation of a Diagnostic Intervention for Cognitively Impaired Elderly, Maastricht University Hospital, Maastricht, the Netherlands.


METHODS
A total of 137 patients who received care in the multidisciplinary diagnostic facility and 93 who received usual care.


METHODS
Quality-adjusted life-years (QALYs) as the main outcome measure and cognition and behavioral problems as secondary outcome measures.


RESULTS
Compared with patients receiving usual care, patients who visited the diagnostic facility gained a mean 0.05 QALY at the extra cost of euro65. The incremental cost per QALY amounted to euro1267. This point estimate lies beneath commonly accepted thresholds and is within an acceptable range of uncertainty. With regard to the secondary analyses, cost-effectiveness results showed a substantial amount of uncertainty and were therefore indecisive.


CONCLUSIONS
On the basis of the main cost-per-QALY analysis, the use of the integrated multidisciplinary diagnostic facility is cost-effective for the diagnosis and management of dementia in ambulatory patients.
Wolfs
Claire A G
CA
Department of Psychiatry and Neuropsychology, University Hospital of Maastricht/Alzheimer Centre Limburg, Maastricht, the Netherlands.
Dirksen
Carmen D
CD
Kessels
Alfons
A
Severens
Johan L
JL
Verhey
Frans R J
FR
D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011795:Surveys and Questionnaires