Abstract
Hungary has a single-payer health insurance system covering 10 million inhabitants. All medical reports of the in- and outpatient specialist services were collected in the NEUROHUN database. We used ICD-10 codes of Alzheimer’s disease (AD), vascular dementia (VaD), miscellaneous dementia group and mild cognitive impairment (MCI) for the inclusion of the patients. Incidence, prevalence and survival of different dementias and MCI were calculated and analyzed depending on the diagnoses given by neurological or psychiatric services or both. Between 2011 and 2016, the mean crude incidence of all dementias was 242/100,000/year, whereas the age standardized incidence was 287/100,000/year. Crude and age standardized mean prevalence rates were 570/100,000 and 649/100,000, respectively. There were significantly more VaD diagnoses than AD, the VaD:AD ratio was 2.54:1, being the highest in patients with psychiatric diagnoses only (4.85:1) and the lowest in patients with only neurological diagnoses (1.32:1). The median survival after the first diagnosis was 3.01 years regarding all dementia cases. Compared to international estimates, the prevalence of dementia and MCI is considerably lower in Hungary and the VaD:AD ratio is reversed.
Highlights
Hungary has a single-payer health insurance system covering 10 million inhabitants
In October 2013, 124 patients were registered in the MedSol system, of which cases were found in the NEUROHUN database
During the examined six-year period, more than 1,956,000 (689,000 neurological, 1,087,000 psychiatric) appearances of 144,407 patients in the Hungarian health care system were associated with any type of dementia diagnosis and 467,063 (148,773 neurological and 318,290 psychiatric) appearances of 21,833 patients with mild cognitive impairment (MCI) alone
Summary
Hungary has a single-payer health insurance system covering 10 million inhabitants. All medical reports of the in- and outpatient specialist services were collected in the NEUROHUN database. Prevalence and survival of different dementias and MCI were calculated and analyzed depending on the diagnoses given by neurological or psychiatric services or both. The prevalence of dementia and MCI is considerably lower in Hungary and the VaD:AD ratio is reversed. The most common causes of dementia in older adults (> 65 years) are Alzheimer’s disease (AD), vascular (VaD) and Lewy body d. Dementia is receiving increased attention due to its significant healthcare, societal and economic burden. In addition to its adverse effects on patients’ and caregivers’ quality of life and life expectancy, huge economic burden for the society is imposed by the increase in the prevalence of dementia: its cost was estimated to be $818 billion in 2 0153,4
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