The effect of telephone support groups on costs of care for veterans with dementia.
OBJECTIVE
Few studies have addressed the effects of caregiver interventions on the costs of care for the care recipient. This study evaluated the effects of a caregiver education and support group delivered via the telephone on care recipient health care utilization and cost.


METHODS
The Telehealth Education Program (TEP) is a manualized program of education and support designed for caregivers of veterans with moderate-to-severe dementia. One hundred fifty-eight spousal caregivers were randomly assigned to either the ten 1-hr sessions of TEP or the usual care (UC). Health care utilization and cost data were extracted from veterans Information System Technology Architecture databases and included outpatient, inpatient, and nursing home data within the VA.


RESULTS
Total health care cost data showed a significant (p = .039) average cost savings of $2,768 per patient at 6 months for TEP as compared with UC, but these were not maintained at 1 year. All costs included in the total costs measure contributed to this difference. Inpatient, outpatient, and nursing home costs were all assessed separately, but only nursing home costs reached significance (p = .009), with a savings of $1,057 per patient at 6 months.


CONCLUSIONS
The TEP caregiver intervention resulted in short-term cost savings for veteran care recipients. Future studies of caregiver interventions should examine their effects on costs of care for the care recipients in addition to their effects on caregiver outcomes.
Wray
Laura O
LO
VA Center for Integrated Healthcare, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14215, USA. laura.wray@va.gov
Shulan
Mollie D
MD
Toseland
Ronald W
RW
Freeman
Kurt E
KE
Vásquez
Bob Edward
BE
Gao
Jian
J
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education* / Q000523:psychology; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000191:economics / Q000451:nursing*; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D012657:Self-Help Groups; D017216:Telemedicine / Q000191:economics* / Q000379:methods; D013689:Telephone; D014728:Veterans