Analysis of the medical demands of elderly dementia patients considering the caregiver cost of medical accompaniment: an application of the travel cost method and altruistic utility function

Abstract

This study employed travel cost method, altruism concepts and negative binomial regression model to establish an outpatient medical demand model of the outpatient visits for elderly dementia patients with caregivers. We considered the time and transport costs of caregivers and evaluated the factors. We employed the MMSE, GDS-15, and Barthel index to conduct and evaluate the preliminary screenings of older adults in Tainan, Taiwan, and we selected 201 dependent older adults with a risk of developing Alzheimer’s disease to participate in this study. Our subsequent analysis examined participants’ dementia-related medical records from January 1, 2009 to December 31, 2010. The findings show that medical visits reduce as the time cost of the accompanying caregiver increases. However, the frequency of medical visits increases with the level of patients’ financial independence. In addition, patients that also suffer from other chronic illnesses further reduced the number of visits related chiefly to dementia.