Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial.
The objectives of this cross-sectional analysis were to determine healthcare resource utilization and cost for community-dwelling patients with dementia (PWD) from a payer's and societal perspective, and to analyze the associations between costs and sociodemographic and clinical variables. Analysis of healthcare costs from a payer's perspective was based on a sample of 425 PWD, analysis of healthcare costs from societal perspective on a subsample of 254 PWD and their informal caregivers. Frequency of healthcare resource utilization was assessed by means of questionnaires. Informal care and productivity losses were assessed by using the Resource Utilization in Dementia questionnaire (RUD). Costs were monetarized using standardized unit costs. To analyze the associations, multiple linear regression models were used. Total annual costs per PWD valued 7016€ from a payer's and 25,877€ from a societal perspective, meaning that societal cost is approximately three and a half times as much as payer's expenditures. Costs valuated 5456 € for medical treatments, 1559 € for formal care, 18,327€ for informal care. Productivity losses valued 1297€ for PWD caregivers. Informal care could vary substantially (-21%; +33%) concerning different valuation methods. Medical care costs decreased significantly with progression of dementia and with age. Costs of care double over the stages of dementia. Formal care costs were significantly higher for PWD living alone and informal care costs significantly lower for PWD with an employed caregiver. For all cost categories, deficits in daily living activities were major cost drivers.
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany. bernhard.michalowsky@dzne.de.
Bernhard
B
Michalowsky
Department of General Business Administration and Health Care Management, Ernst Moritz Arndt University Greifswald, 17489, Greifswald, Germany.
Steffen
S
Flessa
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Tilly
T
Eichler
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Johannes
J
Hertel
Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Adina
A
Dreier
Department Interventional Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Ina
I
Zwingmann
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Diana
D
Wucherer
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Henriette
H
Rau
Department Interventional Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Jochen René
JR
Thyrian
Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.|Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany.
Wolfgang
W
Hoffmann
D017028:Caregivers; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003697:Delphi Technique; D003704:Dementia / Q000191:economics / Q000628:therapy*; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data
Alzheimer´s disease; Cost of illness; Dementia; Healthcare utilization