Abstract
We study the economic cost of dementia in Chile, and its variation according to socioeconomic status (SES). We use primary data from a survey of 330 informal primary caregivers who completed both a RUD-Lite and a socio-demographic questionnaire to evaluate the severity of dementia and caregiver’s burden. The costs of dementia are broken into three components: direct medical costs (medical care, drugs, tests); direct social costs (social service, daycare); and indirect costs (mostly associated to informal care). The average monthly cost per patient is estimated at US$ 1,463. Direct medical costs account for 20 per cent, direct social costs for 5 per cent and indirect costs for 75 per cent of the total cost. The mean monthly cost is found to be inversely related to SES, a pattern largely driven by indirect costs. The monthly cost for high SES is US$ 1,083 and US$ 1,588 for low SES. A multivariate regression analysis suggests that severity of dementia and caregiver’s burden account for between 49 and 70 per cent of the difference in the indirect cost across SES. However, between one-third and one-half of the variation across SES is not due to gradient in severity of dementia. Direct medical costs increase in higher SES, reflecting differences in purchasing power, while indirect costs are inversely related to SES and more than compensate differences in medical costs. Moreover, in lower SES groups, female caregivers, typically family members who are inactive in the labor market, mostly provide informal care. The average annual cost of dementia in Chile (US$ 17,559) is lower in comparison to high-income countries (US$ 39,595) and the proportion of cost related to informal cost is higher (74 per cent compared to 40 per cent). SES is a key determinant in the cost of dementia. In the absence of universal access to treatment, part of the social cost of dementia potentially preserves or increases income and gender inequality.
Highlights
In 2015, 46.8 million people were living with dementia
In 2010, the total estimated worldwide cost of dementia was US$ 817.9 billion, roughly one percent of global gross domestic product (GDP). This cost has three components: i) direct costs that include medical expenses, ii) social costs associated with paid formal caregiving by health professionals or institutionalization, and iii) indirect costs associated with informal caregivers–family members, friends or neighbors–who are unpaid but forgo paid jobs and thereby suffer a productivity loss
This study uses primary data from a survey of 330 Chilean dementia patients and caregivers to estimate the annual costs of dementia and how they vary across socioeconomic status (SES) groups
Summary
In 2015, 46.8 million people were living with dementia This number is expected to double every twenty years, reaching 131.5million in 2050. In 2010, the total estimated worldwide cost of dementia was US$ 817.9 billion, roughly one percent of global gross domestic product (GDP). This cost has three components: i) direct costs that include medical expenses (visits, tests, medicines), ii) social costs associated with paid formal caregiving by health professionals or institutionalization, and iii) indirect costs associated with informal caregivers–family members, friends or neighbors–who are unpaid but forgo paid jobs and thereby suffer a productivity loss
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