Direct costs of dementia in nursing homes.

Hilma Caravau,Ignacio Martín

doi:10.3389/fnagi.2015.00146

Abstract

Dementia represents an economical burden to societies nowadays. Total dementia expenses are calculated by the sum of direct and indirect costs. Through the stages of the diseases, as the patients may require institutionalization or a formal caregiver, the direct costs tend to increase. This study aims to analyze the direct costs of dementia in Portuguese nursing homes in 2012, compare the spending between seniors with and without dementia, and propose a predictive costs model. The expenses analysis was based on (1) the use of emergency rooms and doctor's appointments, either in public or private institutions; (2) days of hospitalization; (3) medication; (4) social services use; (5) the need for technical support; and (6) the utilization of rehabilitation services. The sample was composed of 72 people, half with dementia and half without. The average annual expense of a patient with dementia was €15,287 thousand, while the cost of a patient without dementia was about €12,289 thousand. The variables “ability to make yourself understood,” “self-performance: getting dressed” and “thyroid disorders” were found to be statistically significant in predicting the expenses' increase. In nursing homes, in 2012, the costs per patient with dementia were 1, 2 times higher than per patient without dementia.

Highlights

Dementia encompasses a number of diseases and conditions with specific characteristics, such as cognitive impairment, functional, and behavioral (Reitz et al, 2011), and is a major cause of disability in old age (World Health Organization and Alzheimer’s Disease International, 2012).In 2010, the number of people with dementia in the world was estimated at 35.6 million
The economic impact of dementia in society is connected with the resources used to prevent, diagnose, treat, rehabilitate, and cope with the illness (Huang et al, 1988; O’Shea and O’Reilly, 2000)
This study aims to analyze the direct costs of dementia in Portuguese nursing homes in 2012, compare the spending between seniors with and without dementia, and propose a predictive costs model using the selected variables of the Resident Assessment Instrument-Resource Utilization Group (RAI-RUG) (Gray et al, 2008)

Summary

Introduction

Dementia encompasses a number of diseases and conditions with specific characteristics, such as cognitive impairment, functional, and behavioral (Reitz et al, 2011), and is a major cause of disability in old age (World Health Organization and Alzheimer’s Disease International, 2012). The direct costs represent the resources used (Wimo et al, 2007), which tend to increase with the progression of the disease, with institutionalization, or when there is a need for a caregiver. In 2008, the EuroCoDe project, considering 7.23 million people with dementia, estimated that the total cost of dementia in the European Union 27 (EU27) was around e160 billion (e22,000 per patient per year). Out of this amount, 56% of the cases were attributed to informal care costs and the remaining 44% to direct costs (Wimo et al, 2011). This protocol is a document of the Unit for Research and Education on Adults and Elders (UNIFAI)

Methods

Results

LIMITATIONS