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Determinants of tim...
Determinants of time to institutionalisation and related healthcare and societal costs in a community-based cohort of patients with Alzheimer's disease dementia
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- Belger, Mark (author)
- Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England
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- Haro, Josep Maria (author)
- Univ Barcelona, CIBERSAM, Barcelona, Spain
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- Reed, Catherine (author)
- Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England
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- Happich, Michael (author)
- Eli Lilly & Co Ltd, Lilly Res Ctr, Windlesham, Surrey, England
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- Argimon, Josep Maria (author)
- Agencia Qualitat & Avaluacio Sanitaries Catalunya, Barcelona, Spain
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- Bruno, Giuseppe (author)
- Sapienza Univ Rome, Clin Memoria, Dept Neurol & Psychiat, Rome, Italy
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- Dodel, Richard (author)
- Essen Univ Hosp, Geriatrie Zentrum Haus Berge, Essen, Germany
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- Jones, Roy W. (author)
- Royal United Hosp, RICE Res Inst Care Older People, Bath, Avon, England
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- Vellas, Bruno (author)
- Toulouse Univ Hosp, Gerontopole, INSERM 1027, Toulouse, France
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- Wimo, Anders (author)
- Karolinska Institutet,Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Karolinska Inst, Div Neurogeriatr, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden
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(creator_code:org_t)
- 2018-09-03
- 2019
- English.
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In: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 20:3, s. 343-355
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Abstract
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- Objectives: To examine the costs of caring for community-dwelling patients with Alzheimer’s disease (AD) dementia in relation to the time to institutionalisation.Methods: GERAS was a prospective, non-interventional cohort study in community-dwelling patients with AD dementia and their caregivers in three European countries. Using identified factors associated with time to institutionalisation, models were developed to estimate the time to institutionalisation for all patients. Estimates of monthly total societal costs, patient healthcare costs and total patient costs (healthcare and social care together) prior to institutionalisation were developed as a function of the time to institutionalisation.Results: Of the 1495 patients assessed at baseline, 307 (20.5%) were institutionalised over 36 months. Disease severity at baseline [based on Mini-Mental State Examination (MMSE) scores] was associated with risk of being institutionalised during follow up (p < 0.001). Having a non-spousal informal caregiver was associated with a faster time to institutionalisation (944 fewer days versus having a spousal caregiver), as was each one-point worsening in baseline score of MMSE, instrumental activities of daily living and behavioural disturbance (67, 50 and 30 fewer days, respectively). Total societal costs, total patient costs and, to a lesser extent, patient healthcare-only costs were associated with time to institutionalisation. In the 5 years pre-institutionalisation, monthly total societal costs increased by more than £1000 (€1166 equivalent for 2010) from £1900 to £3160 and monthly total patient costs almost doubled from £770 to £1529.Conclusions: Total societal costs and total patient costs rise steeply as community-dwelling patients with AD dementia approach institutionalisation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Alzheimer's disease
- Societal costs
- Institutionalisation
- Predictors
- Caregiver
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Belger, Mark
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Haro, Josep Mari ...
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Reed, Catherine
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Happich, Michael
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Argimon, Josep M ...
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Bruno, Giuseppe
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Dodel, Richard
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Jones, Roy W.
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Vellas, Bruno
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Wimo, Anders
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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European Journal ...
- By the university
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Uppsala University
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Karolinska Institutet