Real‐world use and cost of health and social care services of 18,116 patients living with Alzheimer’s disease

Abstract

AbstractBackgroundThe increasing prevalence of Alzheimer’s disease (AD) will substantially impact health and social care systems worldwide. In this study, we aimed to estimate the real‐world use and cost of health and social care services in a large cohort of AD patients in the United Kingdom.MethodWe conducted a retrospective cohort study using Discover‐NOW, a real‐world database containing linked primary and secondary care electronic health records of people living in North‐West London, England. A total of 18,116 patients diagnosed with AD were followed from first observed AD diagnosis to end of patient follow up, within the time window from 1 January 2010 to 31 December 2021. The baseline prevalence of 33 comorbidities, survival duration, health and social care resource utilisation and total direct health and social care costs (in 2019 terms) were estimated.ResultOf 18,116 patients with AD, 8,970 (50%) used social care after diagnosis. Most patients using social care were female (65% vs 62% in the general AD population) and were a similar age at diagnosis (median 82 years) compared to those who did not. Of the patients with social care utilisation, 5,248 (59%) resided in care homes and 2,636 (29%) received domiciliary care at home. Annual direct social and health care costs for each patient receiving social care were £25,664 and £6,248 respectively, constituting an annual total cost of £31,912. Median survival from time of AD diagnosis was 4.9 years in the general AD population and 1.9 years after care home admission. Patients who entered care homes, entered at a median age of 85 years and had higher baseline prevalence of stroke (11% vs 7%), chronic kidney disease (40% vs 35%), and atrial fibrillation (17% vs 13%) than the general AD population.ConclusionIn AD patients who used social care, social care costs were >4 times other healthcare costs. Slowing or delaying the requirement for social care would have a major impact on reducing the societal and economic burden of AD on patients and society.