Skip to main content
SpringerLink
Log in

Costs of dementia in Hungary

  • JNHA: Clinical Neurosciences
  • Published:
The journal of nutrition, health & aging

Abstract

Objective

The main aim of this paper is to give an overview on the quality of life, health care utilisation and costs of dementia in Hungary.

Method

A cross-sectional non-population based study of 88 consecutive dementia patients and their caregivers was conducted in three GP practices and one outpatient setting in 2008. Resource Utilization in Dementia (RUD), Mini Mental State Examination (MMSE) and quality of life (EQ-5D) were surveyed and cost calculations were performed. Costs of patients living at home were estimated by the current bottom-up cost-of-illness calculations, while costs of nursing home patients were considered by official reimbursement to determine the disease burden from a societal viewpoint.

Results

The mean age of the patients was 77.4 years (SD=9.2), 59% of them were female. The mean MMSE score was 16.70 (SD=7.24), and the mean EQ-5D score was 0.40 (SD=0.34). The average annual cost of dementia was 6,432 Euros per patient living at home and 6,086 Euros per patient living in nursing homes. For the whole demented population (based on EuroCoDe data) we estimated total annual costs of 846.8 million Euros; of which 55% are direct costs, 9% indirect costs and 36% informal care cost. Compared to acute myocardial infarction the total disease burden of dementia is 26.3 times greater.

Conclusions

This is the first study investigating resource utilisation, costs, and quality of life of dementia patients in the Central and Eastern European region. Compared to the general population of Hungary EQ-5D values of the demented patients are lower in all age groups. Dementia related costs are much lower in Hungary compared to Western European countries. There is no remarkable difference between the costs of demented patients living at home and in nursing homes, from the societal point of view.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AD:

Alzheimer's disease

EuroCoDe:

European Collaboration on Dementia

EQ-5D:

European Quality of life 5 Dimensions

IADL:

Instrumental activity of daily living

MCI:

Mild cognitive impairment

PADL:

Physical activity of daily living

MMSE:

Mini-Mental State Examination

RUD:

Resource Utilization in Dementia

SD:

Standard deviations

NHIFA:

National Health Insurance Fund Administration

References

  1. Brodszky V, Balint P, Geher P, Hodinka L, Horvath G, Koo E et al. Disease Burden of Psoriatic Arthritis Compared to Rheumatoid Arthritis, Hungarian Experiment. Rheum Int 2009;30(2):199–205

    Article  Google Scholar 

  2. Minier T, Péntek M, Brodszky V, Ecseki A, Kárpáti K, Polgár A. Cost-of-illness of patients with systemic sclerosis in a tertiary care centre. Rheumatology. Doi: 10.1093/rheumatology/keq165

  3. Péntek M, Kobelt G, Czirják L, Szekanecz Z, Poór G, Rojkovich B et al. Costs of rheumatoid arthritis in Hungary. J Rheumatol. 2007 Jun;34(6):1437

    PubMed  Google Scholar 

  4. Gabányi J, Mónok G, Demencia diagnózisú kórházi esetek költségelemzése, OEP, 2003.

  5. Falusi Zs, Gabányi J, Gulácsi L, A demencia epidemiológiája és költsége Magyarországon; jelenlegi helyzet és a várható trendek, Egészségügyi Gazdasági Szemle, 2004;43:1:50–58.

    Google Scholar 

  6. Kovács T., Bereczki D., Dementia: The Hungarian perspective, Corvinus Health Policy and Health Economics Miniconference November 12, 2009. http://http://hecon.uni-corvinus.hu/download/conferences/nov.12/K.Tibor_CorvinusAD_ea_KT.pdf Downloaded: 12.01.2010

  7. Estimated number of people (2006) with dementia. Alzheimer Europe 2009 http://ec.europa.eu/health/ph_information/dissemination/echi/docs/dementia2_en.pdf Downloaded: 29.12.2009

  8. Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers Dement. 2010 Mar;6(2):98–103.

    Article  PubMed  Google Scholar 

  9. Wimo A, Jönsson L, Gustavsson A. Cost of illness and burden of dementia — The base option. Alzheimer Europe. http://www.alzheimer-europe.org/EN/Our-Research/European-Collaboration-on-Dementia/Cost-of-dementia/Cost-of-illnessand-burden-of-dementia Downloaded: 29.12.2009

  10. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr. 2007;44(1):71–81.

    Article  PubMed  Google Scholar 

  11. Jonsson L, Berr C. Cost of dementia in Europe. Eur J Neurol. 2005 Jun;12Suppl 1:50–53.

    Article  PubMed  Google Scholar 

  12. Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12Suppl 1:1–27.

    Article  PubMed  Google Scholar 

  13. SBU. Dementia. A systematic review. Stockholm: Staten beredning för medicinsk utvärdering (SBU) (The Swedish Council on Technology Assessment in Health Care) 2008. Report No.: 172E/1-3

  14. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005 Dec 17;366(9503):2112–2117.

    Article  PubMed  Google Scholar 

  15. Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, et al. Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000;54(11 Suppl 5):S4–S9.

    CAS  PubMed  Google Scholar 

  16. Hofman A, Rocca WA, Brayne C, Breteler MM, Clarke M, Cooper B, et al. The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. Eurodem Prevalence Research Group. Int J Epidemiol. 1991 Sep;20(3):736–748.

    Article  CAS  PubMed  Google Scholar 

  17. Wimo A, Nordberg G, Jansson W, Grafström M. Assessment of informal services to demented people with the RUD instrument. Int J Geriatr Psychiatry. 2000;15(10):969–971.

    Article  CAS  PubMed  Google Scholar 

  18. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr. 2007;44(1):71–81.

    Article  PubMed  Google Scholar 

  19. Guerrero-Berroa E, Luo X, Schmeidler J, Rapp MA, Dahlman K, Grossman HT, Haroutunian V, Beeri MS. The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly. Int J Geriatr Psychiatry. 2009;24(12):1429–1437.

    Article  PubMed  Google Scholar 

  20. Hungarian Central Statistical Office online database, www.ksh.hu

  21. NHIFA online database, www.oep.hu

  22. Hungarian Tax and Financial Control Administration database, http://en.apeh.hu/

  23. National Audit Office Report Nr. 0820. Summary of the Audit of the Utilization of Funds Appropriated for Nursing by Hospitals and Residential Social Institutions of Local Governments (http://www.asz.hu/ASZ/www.nsf/reports.html)

  24. Jonsson L, Lindgren P, Wimo A, Jonsson B, Winblad B. Costs of MMSE-related Cognitive Impairment. Pharmacoeconomics. 1999;16:409–416.

    Article  CAS  PubMed  Google Scholar 

  25. Szende A, Németh R. Health-related quality of life of the Hungarian population. Orv Hetil. 2003;144:1667–1674.

    PubMed  Google Scholar 

  26. Wimo A, Jönsson L, Gustavsson A. Regional/National cost of illness estimates. Alzheimer Europe: http://www.alzheimer-europe.org/Our-Research/European-Collaboration-on-Dementia/Cost-of-dementia/Regional-National-cost-of-illnessestimates Downloaded: 29.12.2009

  27. Gulácsi L, Májer I, Boncz I, Brodszky V, Merkely B, Maurovich Horváth P, Kárpáti K. Hospital costs of acute myocardial infarction in Hungary; 2003–2005. Orv Hetil. 2007;148(27):1259–1266.

    Article  PubMed  Google Scholar 

  28. Leél- ssy L, Sz cs I, Kindler M, Schwarz T. Incidence of Alzheimer pathology in the autopsy material of two hospitals (1996–1997) Clin. Neurosci./Ideggyogy Sz. 1998; 51/suppl. 1:34–35

    Google Scholar 

  29. Leél- ssy L, Kindler M, Sz cs I, Schwarcz T. Neuropathologic investigation in autopsies with special emphasis on findings in Alzheimer's disease. Clin. Neurosci./Ideggyogy Sz. 2006,. 59(5–6):164–177.

    Google Scholar 

  30. Kovács GG, Kovári V, Nagy Z. Frequency of different forms of dementia at the Department of Neuropathology of the Hungarian National Institute of Psychiatry and Neurology during a 3-year period. Clin Neurosci/ Ideggyogy. Sz. 2008;61(1–2) p. 24–32.

    Google Scholar 

  31. Leel- ssy, L. Incidence of Alzheimer's dementia in homes for the elderly. Arch Gerontol Geriatr. 1995;21(1):21–26.

    Article  Google Scholar 

  32. Tariska P, Knolmayer J, Kiss é, Urbanics K, Mészáros á, Angyalosné Takó E, Mihocsa I, Baranyai Zs. The first Memory Clinic in Hungary: Experiences based on the data of the first five-year period. Clin Neurosci/ Ideggyogy Sz. 1998; 51/suppl 1.: 40–42.

    Google Scholar 

  33. Kálmán J, Boda K, Bende Z, Janka Z. Screening for dementia syndromes: the Hungarian experience with the 7-Minute-Test. Orv Hetil. 2003;144(39):1929–1938.

    PubMed  Google Scholar 

  34. Tariska P, Paksy A. Mini-Cog: a simple method for very brief screening of mental decline. Orv Hetil. 2003;144(17):803–809.

    PubMed  Google Scholar 

  35. Vincze G, Almos P, Boda K, Döme P, Bódi N, Szlávik G, Maglóczki E, Pákáski M, Janka Z, Kálmán J. Risk factors of cognitive decline in residential care in Hungary. Int J Geriatr Psychiatry. 2007;22(12):1208–1216.

    Article  PubMed  Google Scholar 

  36. Linka E, Kispál Gy, Szabó T, Bartkó Gy. A dementia sz rése és a betegek egyéves követése egy háziorvosi praxisban. Clin Neurosci/ Ideggyogy Sz. 2001. 54(5–6)

  37. Leel- ssy L, Józsa I, Sz s I, Kindler M. Sz r vizsgálatok a dementia korai felderítésére (Családorvosi körzetekben és id sek otthonában). Medicus Universalis 2005. (3)

  38. Érsek K, Kárpáti K, Kovács T, Csillik G, Gulácsi LÁ, Gulácsi L: Epidemiology of Dementia in Hungary. Clin. Neurosci./Ideggyogy. Sz. — 2010; 63(5–6): 175–182.

    Google Scholar 

  39. Pommer E, Woittiez I, Stevens J. Comparing Care. The care of the elderly in ten EU-countries. The Netherlands Institute for Social Research (SCP). Publication number: 2007/32.

  40. Health, Ageing and Retirement in Europe. First Results from the Survey of Health, Ageing and Retirement in Europe (SHARE) Mannheim Research Institute for the Economics of Aging (MEA), 2005.

Download references

Author information

Authors and Affiliations

  1. Health Economics and Health Technology Assessment Research Centre, Corvinus University of Budapest, Budapest, Hungary

    K. Érsek, K. Kárpati, V. Brodszky, M. Péntek & L. Gulácsi

  2. Department of Neurology, Semmelweis University, Budapest, Hungary

    T. Kovács

  3. Karolinska Institute, Stockholm, Sweden

    A. Wimo

  4. European Health Economics, London, UK

    L. Jönsson & A. Gustavsson

  5. London School of Economics and Political Science, London, UK

    D. McDaid

  6. Fondation Médéric Alzheimer, Paris, France

    P. A. Kenigsberg

  7. University of Eastern Finland, Kuopio, Finland

    H. Valtonen

Authors
  1. K. Érsek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Kovács
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Wimo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Kárpati
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. V. Brodszky
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Péntek
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Jönsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Gustavsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. D. McDaid
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. P. A. Kenigsberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. H. Valtonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. L. Gulácsi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Érsek, K., Kovács, T., Wimo, A. et al. Costs of dementia in Hungary. J Nutr Health Aging 14, 633–639 (2010). https://doi.org/10.1007/s12603-010-0309-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-010-0309-1

Key words

Search

Navigation