Determinants of care costs of patients with dementia or cognitive impairment.
BACKGROUND
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 &OV0556;26,140 ($34,505 or £17,775) and &OV0556;11,931 ($15,749 or £8113) 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.
Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), University Medical Centre, AZ Maastricht, The Netherlands. ron.handels@maastrichtuniversity.nl
Ron L H
RL
Handels
Claire A G
CA
Wolfs
Pauline
P
Aalten
Frans R J
FR
Verhey
Johan L
JL
Severens
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003072:Cognition Disorders / Q000191:economics*; D003661:Decision Support Techniques; D003704:Dementia / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged