Abstract
ObjectiveGiven the shortage of cost-of-illness studies in dementia outside of the Western population, the current study estimated the annual cost of dementia in Taiwan and assessed whether different categories of care costs vary by severity using multiple disease-severity measures.MethodsThis study included 231 dementia patient–caregiver dyads in a dementia clinic at a national university hospital in southern Taiwan. Three disease measures including cognitive, functional, and behavioral disturbances were obtained from patients based on medical history. A societal perspective was used to estimate the total costs of dementia according to three cost sub-categories. The association between dementia severity and cost of care was examined through bivariate and multivariate analyses.ResultsTotal costs of care for moderate dementia patient were 1.4 times the costs for mild dementia and doubled from mild to severe dementia among our community-dwelling dementia sample. Multivariate analysis indicated that functional declines had a greater impact on all cost outcomes as compared to behavioral disturbance, which showed no impact on any costs. Informal care costs accounted for the greatest share in total cost of care for both mild (42%) and severe (43%) dementia patients.ConclusionsSince the total costs of dementia increased with severity, providing care to delay disease progression, with a focus on maintaining patient physical function, may reduce the overall cost of dementia. The greater contribution of informal care to total costs as opposed to social care also suggests a need for more publicly-funded long-term care services to assist family caregivers of dementia patients in Taiwan.
Highlights
Cost-of-illness (COI) studies provide estimates about the economic impact of diseases and offer comprehensive data to assist decision makers for purposes of planning and financing of health systems [1]
Informal care costs accounted for the greatest share in total cost of care for both mild (42%) and severe (43%) dementia patients
The greater contribution of informal care to total costs as opposed to social care suggests a need for more publicly-funded long-term care services to assist family caregivers of dementia patients in Taiwan
Summary
Cost-of-illness (COI) studies provide estimates about the economic impact of diseases and offer comprehensive data to assist decision makers for purposes of planning and financing of health systems [1]. Cultural traditions in East Asia often make adult children reluctant to send their parents with dementia to nursing homes; the utilization of formal versus informal care can be influenced by culture and affects COI [7]. It is important for each nation to have country-specific data on cost of care at different stages of dementia for health policy planning [8]
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