title: An Analysis of the Public Financial Support Eligibility Rule for French Dependent Elders with Alzheimer's Disease.
abstract: BACKGROUND
  It is crucial to define health policies that target patients with the highest needs. In France, public financial support is provided to dependent patients: it can be used to finance informal care time and nonmedical care use. Eligibility for public subsidies and reimbursement of costs is associated with a specific tool: the autonomie gérontologie groupes iso-ressources (AGGIR) scale score.
  
  
  OBJECTIVE
  Our objective was to explore whether patients with Alzheimer's disease who are eligible for public financial support have greater needs than do noneligible patients.
  
  
  METHODS
  Using data from the Dépendance des patients atteints de la maladie d'Alzheimer en France study, we calculated nonmedical care expenditures (in €) using microcosting methods and informal care time demand (hours/month) using the Resource Use in Dementia questionnaire. We measured the burden associated with informal care provision with Zarit Burden Interview. We used a modified two-part model to explore the correlation between public financial support eligibility and these three variables.
  
  
  RESULTS
  We find evidence of higher informal care use, higher informal caregivers' burden, and higher care expenditures when patients have an AGGIR scale score corresponding to public financial support eligibility.
  
  
  CONCLUSIONS
  The AGGIR scale is useful to target patients with the highest costs and needs. Given our results, public subsidies could be used to further sustain informal caregivers networks by financing programs dedicated to lowering informal caregivers' burden.
authors: LIRAES, University of Paris Descartes, Paris, France. Electronic address: thomas.rapp@parisdescartes.fr.
authors: Thomas
authors: T
authors: Rapp
authors: Lacey Solutions, Dublin, Ireland.
authors: Loretto
authors: L
authors: Lacey
authors: CHU Toulouse, Toulouse, France.
authors: Pierre-Jean
authors: PJ
authors: Ousset
authors: ISPED, Bordeaux France.
authors: Pascale
authors: P
authors: Cowppli-Bony
authors: CHU Toulouse, Toulouse, France.
authors: Bruno
authors: B
authors: Vellas
authors: ISPED, Bordeaux France.
authors: Jean-Marc
authors: JM
authors: Orgogozo
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D017028:Caregivers / Q000191:economics; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics; D004608:Eligibility Determination / Q000191:economics*; D005260:Female; D005602:France; D005102:Health Expenditures; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007407:Interviews as Topic; D008297:Male; D008483:Medical Assistance / Q000191:economics*; D018803:Models, Economic; D009313:National Health Programs / Q000191:economics*; D020380:Needs Assessment / Q000191:economics*; D005791:Patient Care / Q000191:economics*; D017150:Public Sector / Q000191:economics*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Alzheimer’s disease; dependence; informal care