Cost Effective Community Based Dementia Screening: A Markov Model Simulation

Erin Saito,Aaron Mcmurtray,Mario F Mendez,Beau K Nakamoto,Bijal Mehta

doi:10.1155/2014/103138

Abstract

Background. Given the dementia epidemic and the increasing cost of healthcare, there is a need to assess the economic benefit of community based dementia screening programs. Materials and Methods. Markov model simulations were generated using data obtained from a community based dementia screening program over a one-year period. The models simulated yearly costs of caring for patients based on clinical transitions beginning in pre dementia and extending for 10 years. Results. A total of 93 individuals (74 female, 19 male) were screened for dementia and 12 meeting clinical criteria for either mild cognitive impairment (n = 7) or dementia (n = 5) were identified. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Discussion. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages.

Highlights

Dementia is a major healthcare problem that causes a significant financial burden to society [1]
Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages
While it is possible that more effective treatments may be developed in the future for progressive dementing disorders, our results suggest that community based dementia screening can achieve a substantial cost savings benefit due to more effective use of currently available treatments through earlier detection and treatment compared to providing care without screening

Summary

Introduction

Dementia is a major healthcare problem that causes a significant financial burden to society [1]. A recent Rand Corporation study estimates that the total per person cost of dementia care in the US is about $42,000–$69,000/year [1] Most of this cost is related to caring for patients in the more severe stages of dementia who require institutional and home-based assistance with activities of daily living. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages

Methods

Results

Conclusion