Cost of informal care for community-dwelling mild–moderate dementia patients in a developed Southeast Asian country

2013 ◽  
Vol 25 (9) ◽  
pp. 1475-1483 ◽  
Author(s):  
Mei Sian Chong ◽  
Woan Shin Tan ◽  
Mark Chan ◽  
Wee Shiong Lim ◽  
Noorhazlina Ali ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Informal Care ◽  
Asian Country ◽  
Cost Of Care ◽  
Community Dwelling ◽  
Dementia Patients ◽  
Moderate Dementia ◽  
Domestic Help ◽  
Informal Care Costs ◽  
Care Costs

ABSTRACTBackground: Cost of informal care constitutes an important component of total dementia care cost. It also reflects resource utilization by patients and caregivers. We aim to quantify the informal cost of care for mild to moderate dementia patients.Methods: We recruited 165 patient–caregiver dyads with mild to moderate dementia. Informal care burden was assessed using the Resource Utilization in Dementia (RUD)-Lite instrument. A generalized linear model was fitted for association between cost of informal care and cognitive impairment, taking into account patient demographics, disease factors, and use of paid domestic help. Marginal estimates were obtained from the model for the purpose of illustration and discussion.Results: Total hours of informal care by primary caregiver doubled in moderate dementia patients, with 57.9% having paid domestic help to assist in care. Functional factors and use of paid domestic help were significantly associated with informal care costs. Costs were consistently higher for patients without paid domestic help for mild- and moderate dementia.Conclusion: This study demonstrates the informal care costs of caring for mild–moderate dementia patients in Singapore, with the unique cost savings provided by live-in paid domestic help, and potentially may aid policy-makers in allocation of resources and support to caregivers.

Costs and quality of life in community-dwelling patients with Alzheimer's disease in Spain: results from the GERAS II observational study

2017 ◽  
Vol 29 (12) ◽  
pp. 2081-2093 ◽  
Author(s):  
Javier Olazarán ◽  
Luis Agüera-Ortiz ◽  
Josep María Argimón ◽  
Catherine Reed ◽  
Antonio Ciudad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Informal Care ◽  
Resource Use ◽  
Community Dwelling ◽  
P Value ◽  
Societal Costs ◽  
Informal Care Costs ◽  
Care Costs

ABSTRACTBackground:Country-specific data on resource use and costs associated with Alzheimer's disease (AD) help inform governments about the increasing need for medical and financial support as the disease increases in prevalence.Methods:GERAS II, a prospective observational study, assessed resource use, costs, and health-related quality of life (HRQoL) among patients with AD and their caregivers in Spain. Community-dwelling patients aged ≥55 years with probable AD, and their primary caregivers, were recruited by study investigators during routine clinical practice and assessed as having mild, moderate, or moderately severe/severe (MS/S) AD dementia based on patient Mini-Mental State Examination scores. Costs of AD were calculated by applying costs to resource-use data obtained in caregiver interviews using the Resource Utilization in Dementia instrument. Total societal costs included patients’ health and social care costs and caregiver informal care costs. Baseline results are presented.Results:Total mean monthly societal costs/patient (2013 values) were €1514 for mild (n = 116), €2082 for moderate (n = 118), and €2818 for MS/S AD dementia (n = 146) (p value <0.001 between groups). Caregiver informal care costs comprised most of the total societal costs and differed significantly between groups (€1050, €1239, €1580, respectively; p value = 0.013), whereas patient healthcare costs did not. Across AD dementia severity groups, patient HRQoL (measured by proxy) decreased significantly (p value <0.001), caregiver subjective burden significantly increased (p value <0.001) and caregiver HRQoL was similar.Conclusions:Societal costs associated with AD in Spain were largely attributable to caregiver informal care costs and increased with increasing AD dementia severity.

Factors influencing 2-year health care costs in patients undergoing revision lumbar fusion procedures

2012 ◽  
Vol 16 (4) ◽  
pp. 323-328 ◽  
Author(s):  
Scott L. Parker ◽  
David N. Shau ◽  
Stephen K. Mendenhall ◽  
Matthew J. McGirt
Keyword(s):  
Health Care ◽  
Global Health ◽  
Resource Utilization ◽  
Health Care Costs ◽  
Lumbar Fusion ◽  
Perioperative Complications ◽  
Fold Increase ◽  
Cost Of Care ◽  
Site Infection ◽  
Care Costs

Object Revision lumbar fusion procedures are technically challenging and can be associated with tremendous health care resource utilization and cost. There is a paucity of data regarding specific factors that significantly contribute to increased cost of care. In light of this, the authors set out to identify independent risk factors predictive of increasing 2-year direct health care costs after revision lumbar fusion. Methods One hundred fifty patients undergoing revision instrument-assisted fusion for adjacent-segment disease (50 cases), pseudarthrosis (47 cases), or same-level stenosis (53 cases) were included in this study. Patient demographics, comorbidities, preoperative health states as assessed by patient-reported outcome questionnaires and perioperative complications were collected and analyzed. Two-year back-related medical resource utilization and direct health care costs were assessed. The independent association of all variables to increasing cost was assessed using multivariate linear regression analysis. Results There was a wide range ($24,935–$63,769) in overall 2-year direct costs for patients undergoing revision lumbar fusion (mean $32,915 ± $8344 [± SD]). Preoperative variables independently associated with 2-year direct health care costs included diagnosis of congestive heart failure, more severe leg pain (visual analog scale), greater back-related disability (Oswestry Disability Index), and worse mental health (12-Item Short Form Health Survey Mental Component Summary score). There was a 1.1- to 1.2-fold increase in cost for patients in the greatest quartiles compared with those in the lowest quartiles for these variables. Surgical site infection, return to the operating room, and spine-related hospital readmission during the 90-day global health period were postoperative variables independently associated with 2-year cost. Patients in the greatest versus lowest quartiles had a 1.7- to 1.9-fold increase in cost for these variables. Conclusions Revision lumbar fusion can be associated with considerable 2-year health care costs. These costs can also vary widely among patients, as evidenced by the 2.6-fold overall cost range in this series. Although comorbidities and preoperative severity of disease states contribute to cost of care, the primary drivers of increased cost include perioperative complications such as surgical site infection, return to the operating room, and readmission during the global health period. Measures focused on health service improvement will be most successful in reducing the cost of care for patients undergoing revision lumbar fusion.

A comparative study on costs of cancer and access to medicines in Europe.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19051-e19051
Author(s):  
Nils Erik Wilking ◽  
Gunnar Brådvik ◽  
Peter Lindgren ◽  
Christer Svedman ◽  
Bengt Jönsson ◽  
...  
Keyword(s):  
Informal Care ◽  
Cancer Care ◽  
Health Expenditure ◽  
Productivity Loss ◽  
Premature Mortality ◽  
Access To Medicines ◽  
Cancer Drug ◽  
Large Country ◽  
Informal Care Costs ◽  
Care Costs

e19051 Background: Cancer care is evolving rapidly, and costs and value of new treatments are often causing headlines without being discussed in a larger context. This study estimates the cost of cancer and access to medicines in Europe in 2018 and extends a previous analysis for 1995–2014. Methods: Cancer-specific health expenditure for 31 countries (EU-27 plus Iceland, Norway, Switzerland, and the UK) were derived from national estimates. Data on cancer drug sales were obtained from IQVIA. The productivity loss from premature mortality was estimated from data from Eurostat and the WHO. Estimates of the productivity loss from morbidity and informal care costs were based on previous studies. Results: The total cost of cancer was €199 billion in 2018. Total costs ranged from €160 per capita in Romania to €578 in Switzerland (after adjustment for price differentials). Health expenditure on cancer care was €103 billion, of which €32 billion was spent on cancer drugs. Informal care costs were €26 billion. The total productivity loss was €70 billion, composed of €50 billion from premature mortality and €20 billion from morbidity. Between 1995 and 2018, cancer incidence increased by 50 percent from 2.1 million to 3.1 million cases in Europe. Cancer mortality increased only by 20 percent. Health spending on cancer care doubled from €52 billion to €103 billion (in 2018 prices and exchange rates), whereas the share of cancer care on the total health expenditure remained stable at around 4 to 7 percent. A shift from treatment in inpatient care to ambulatory care has probably saved costs. Expenditure on cancer medicines more than tripled from €10 billion to €32 billion between 2005 and 2018 (excluding confidential rebates). Productivity loss from premature mortality decreased over time, linked to mortality reductions in working-age patients. Conclusions: There are large country differences in spending on cancer care and outcomes in Europe. Access to new cancer medicines is low or very low in certain parts of Europe. Inequalities are mainly related to countries’ economic strength and not to the disease burden of cancer.

Formal and informal care costs of hospitalized older people at risk of poor functioning: A prospective cohort study

2014 ◽  
Vol 59 (2) ◽  
pp. 382-392 ◽  
Author(s):  
Kirsten J.E. Asmus-Szepesi ◽  
Marc A. Koopmanschap ◽  
Linda E. Flinterman ◽  
Ton J.E.M. Bakker ◽  
Johan P. Mackenbach ◽  
...  
Keyword(s):  
At Risk ◽  
Cohort Study ◽  
Older People ◽  
Informal Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Informal Care Costs ◽  
Care Costs

scholarly journals Economic Burden of Alzheimer’s Disease Dementia in Japan

2021 ◽  
pp. 1-11
Author(s):  
Shunya Ikeda ◽  
Masaru Mimura ◽  
Manabu Ikeda ◽  
Kenji Wada-Isoe ◽  
Mie Azuma ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Informal Care ◽  
Economic Burden ◽  
Healthcare Costs ◽  
Long Term Care ◽  
Productivity Loss ◽  
Term Care ◽  
Informal Care Costs ◽  
Care Costs

Background: Alzheimer’s disease dementia (ADD) is the leading cause of long-term care in Japan. Objective: This study estimates the annual healthcare and long-term care costs in fiscal year 2018 for adults over 65 years of age with ADD in Japan and the informal care costs and productivity loss for their families. Methods: Healthcare and long-term care costs for ADD were estimated according to the disease severity classified by the clinical dementia rating (CDR) score, using reports from a literature review. For the costs of time spent on caregiving activities, productivity loss for ADD family caregivers aged 20–69 and informal care costs for all ADD family caregivers were estimated. Results: The total healthcare cost of ADD was JPY 1,073 billion, of which 86% (JPY 923 billion) was attributed to healthcare costs other than ADD drug costs (JPY 151 billion). The healthcare costs other than ADD drug costs by severity were less than JPY 200 billion for CDR–0.5, CDR-1, and CDR-2, respectively, but increased to JPY 447 billion (48%) for CDR-3. The public long-term care costs were estimated to be JPY 4,783 billion, which increased according to the severity. Total productivity loss for ADD family caregivers aged 20–69 was JPY 1,547 billion and the informal care cost for all ADD family caregivers was JPY 6,772 billion. Conclusion: ADD costs have a significant impact on public-funded healthcare, long-term care systems, and families in Japan. To minimize the economic burden of ADD, prolonging healthy life expectancy is the key factor to address.

scholarly journals Using Big Data to Estimate Dementia Prevalence in New Zealand: Protocol for an Observational Study

10.2196/20225 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e20225
Author(s):  
Claudia Rivera-Rodriguez ◽  
Gary Cheung ◽  
Sarah Cullum
Keyword(s):  
Risk Factors ◽  
New Zealand ◽  
Home Care ◽  
Informal Care ◽  
Dementia Prevalence ◽  
Health And Social Care ◽  
Informal Care Costs ◽  
The Cost ◽  
Care Costs ◽  
Prevalence Of Dementia

Background Dementia describes a cluster of symptoms that includes memory loss; difficulties with thinking, problem solving, or language; and functional impairment. Dementia can be caused by a number of neurodegenerative diseases, such as Alzheimer disease and cerebrovascular disease. Currently in New Zealand, most of the systematically collected and detailed information on dementia is obtained through a suite of International Residential Assessment Instrument (interRAI) assessments, including the home care, contact assessment, and long-term care facility versions. These versions of interRAI are standardized comprehensive geriatric assessments. Patients are referred to have an interRAI assessment by the Needs Assessment and Service Coordination (NASC) services after a series of screening processes. Previous estimates of the prevalence and costs of dementia in New Zealand have been based on international studies with different populations and health and social care systems. This new local knowledge will have implications for estimating the demographic distribution and socioeconomic impact of dementia in New Zealand. Objective This study investigates the prevalence of dementia, risk factors for dementia, and drivers of the informal cost of dementia among people registered in the NASC database in New Zealand. Methods This study aims to analyze secondary data routinely collected by the NASC and interRAI (home care and contact assessment versions) databases between July 1, 2014, and July 1, 2019, in New Zealand. The databases will be linked to produce an integrated data set, which will be used to (1) investigate the sociodemographic and clinical risk factors associated with dementia and other neurological conditions, (2) estimate the prevalence of dementia using weighting methods for complex samples, and (3) identify the cost of informal care per client (in number of hours of care provided by unpaid carers) and the drivers of such costs. We will use design-based survey methods for the estimation of prevalence and generalized estimating equations for regression models and correlated and longitudinal data. Results The results will provide much needed statistics regarding dementia prevalence and risk factors and the cost of informal care for people living with dementia in New Zealand. Potential health inequities for different ethnic groups will be highlighted, which can then be used by decision makers to inform the development of policy and practice. Conclusions As of November 2020, there were no dementia prevalence studies or studies on informal care costs of dementia using national data from New Zealand. All existing studies have used data from other populations with substantially different demographic distributions. This study will give insight into the actual prevalence, risk factors, and informal care costs of dementia for the population with support needs in New Zealand. It will provide valuable information to improve health outcomes and better inform policy and planning. International Registered Report Identifier (IRRID) DERR1-10.2196/20225

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