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Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial

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Abstract

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.

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Notes

  1. Exchange rate: 1€ = $1.06763 (November 2015).

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Acknowledgements

Development, co-ordination, and implementation of the DelpHi-MV trial was influenced by input from several experts in their respective field and supported by an experienced field study team: Ines Abraham, Grit Aßmann, Kerstin Albuerne, Vaska Böhmann, Georgia Böwing, Kathleen Dittmer, Thomas Fiß, Sarah Gardzella, Jana Hubert, Ulrike Kempe, Ingo Kiliman, Leonore Köhler, Saskia Moll, Andrea Pooch, Sabine Schmidt, Christiane Schnick, Stefan Teipel, and Christine Winckler.

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Authors and Affiliations

  1. Department Translational Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany

    Bernhard Michalowsky, Tilly Eichler, Johannes Hertel, Diana Wucherer, Henriette Rau & Wolfgang Hoffmann

  2. Department of General Business Administration and Health Care Management, Ernst Moritz Arndt University Greifswald, 17489, Greifswald, Germany

    Steffen Flessa

  3. Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany

    Adina Dreier & Wolfgang Hoffmann

  4. Department Interventional Health Care Research, German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, 17487, Greifswald, Germany

    Ina Zwingmann & Jochen René Thyrian

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  1. Bernhard Michalowsky
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Michalowsky, B., Flessa, S., Eichler, T. et al. Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial. Eur J Health Econ 19, 87–102 (2018). https://doi.org/10.1007/s10198-017-0869-7

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