scholarly journals Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026733 ◽  
Author(s):  
Takayo Nakabe ◽  
Noriko Sasaki ◽  
Hironori Uematsu ◽  
Susumu Kunisawa ◽  
Anders Wimo ◽  
...  
Keyword(s):  
Informal Care ◽  
Economic Burden ◽  
Online Survey ◽  
Economic Status ◽  
Dementia Care ◽  
Cross Sectional ◽  
People With Dementia ◽  
Out Of Pocket Payments ◽  
Informal Care Costs ◽  
Care Costs

ObjectiveThe purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.DesignA cross-sectional online survey.Participants4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.Primary outcome measuresInformal care costs and out-of-pocket payments for long-term care (LTC) services.ResultsFrom 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.ConclusionThis study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.

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.

Longitudinal costs of caring for people with Alzheimer's disease

2014 ◽  
Vol 27 (5) ◽  
pp. 847-856 ◽  
Author(s):  
Paddy Gillespie ◽  
Eamon O’Shea ◽  
John Cullinan ◽  
Jacqui Buchanan ◽  
Joel Bobula ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Multivariate Analysis ◽  
Informal Care ◽  
Current Evidence ◽  
People With Dementia ◽  
Informal Care Costs ◽  
Care Costs ◽  
Over Time

ABSTRACTBackground:There has been an increasing interest in the relationship between severity of disease and costs in the care of people with dementia. Much of the current evidence is based on cross-sectional data, suggesting the need to examine trends over time for this important and growing cohort of the population.Methods:This paper estimates resource use and costs of care based on longitudinal data for 72 people with dementia in Ireland. Data were collected from the Enhancing Care in Alzheimer's Disease (ECAD) study at two time points: baseline and follow-up, two years later. Patients’ dependence on others was measured using the Dependence Scale (DS), while patient function was measured using the Disability Assessment for Dementia (DAD) scale. Univariate and multivariate analysis were used to explore the effects of a range of variables on formal and informal care costs.Results:Total costs of formal and informal care over six months rose from €9,266 (Standard Deviation (SD): 12,947) per patient at baseline to €21,266 (SD: 26,883) at follow-up, two years later. This constituted a statistically significant (p = 0.0014) increase in costs over time, driven primarily by an increase in estimated informal care costs. In the multivariate analysis, a one-point increase in the DS score, that is a one-unit increase in patient's dependence on others, was associated with a 19% increase in total costs (p = 0.0610).Conclusions:Higher levels of dependence in people with Alzheimer's disease are significantly associated with increased costs of informal care as the disease progresses. Formal care services did not respond to increased dependence in people with dementia, leaving it to families to fill the caring gap, mainly through increased supervision with the progress of disease.

scholarly journals LEVEL OF KNOWLEDGE AND ATTITUDE ON DEMENTIA CARE AMONG NURSES

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Chong Kar Lim ◽  
Chang Woan Ching ◽  
Leow Jing Jun ◽  
Ling Yun
Keyword(s):  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Attitude Scale ◽  
Dementia Care ◽  
Cross Sectional ◽  
Training Strategy ◽  
Healthcare Settings ◽  
People With Dementia ◽  
Level Of Knowledge ◽  
Knowledge And Attitude

Background: It is a concern in meeting patients’ needs with a high prevalence of dementia across the world. However, dementia care has always been neglected. Nurses are expected to be capable of being able to care for people with dementia. Purpose: This study aims to determine the level of knowledge and attitude on dementia care and their association among nurses at a private hospital. Methods: This is a quantitative cross-sectional study. A self-administered questionnaire using Dementia Knowledge Assessment Scale (DKAS) and Dementia Attitude Scale (DAS) were adopted in the study. In this study, a simple random sampling method was used to recruit 102 nurses. Results: Findings show that nurses have poor knowledge (M=23.59, SD=6.79) but with a positive attitude (M=98.99, SD=12.08) on dementia care. There is no association between level of knowledge and attitude in dementia care (p> .05) among nurses. Conclusions: The educators, policy makers and administrators in healthcare settings are recommended to provide a support system and training strategy for nurses to improve their knowledge in caring for patients with dementia. Future study may be considered to examine the influencing factors and barriers related to dementia care.

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.

scholarly journals A comparative study of dementia knowledge, attitudes and care approach among Chinese nursing and medical students

2020 ◽  
Author(s):  
Yao Wang ◽  
Lily Dongxia Xiao ◽  
Rong Huang
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Professional Education ◽  
Attitude Scale ◽  
Dementia Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
People With Dementia ◽  
Study Results ◽  
Care Approach

Abstract BackgroundDementia care requires inter-disciplinary collaboration starting from formal health professional education. Yet, little is known about how undergraduate medical and nursing students perceive dementia care in China. The aim of this study was to investigate undergraduate medical and nursing students’ dementia knowledge, attitudes and care approach in China.Methods A cross-sectional survey was conducted. Students enrolled in a 5-year Bachelor of Medicine Program and a 4-year Bachelor of Nursing Program from four universities with campuses across Eastern, Western, Southern and Northern China were recruited into the study. Three validated instruments, Alzheimer’s Disease Knowledge Scale (ADKS), Dementia Care Attitude Scale (DCAS) and Approach to Advanced Dementia Care Questionnaire (ADCQ), were used to examine students’ dementia knowledge, attitudes and perceived care approach. Data were collected using a self-administered survey.ResultsThe number of medical and nursing students completing the survey was 526 and 467 respectively. Students’ overall knowledge about dementia was poor, but attitudes were generally positive. The overall mean score of students’ dementia knowledge examined by the ADKS was 19.49 (SD=2.82) out of 30, students’ attitudes to dementia was 29.92(SD=3.35) out of 40, and students’ person-centred care approach of dementia was 5.42 (SD=2.20) out of 13. Medical students demonstrated higher dementia knowledge scores and showed less positive attitude scores than nursing students (p<0.05). Students would not apply a person-centred care approach. There were no statistically significant differences in the mean scores of ADCQ between nursing students and medical students.Conclusions Study results highlight the urgent need to implement an inter-disciplinary approach to increasing dementia education among Chinese medical and nursing students, and ensuring that students have adequate knowledge, attitudes and experience in the care of people with dementia.

scholarly journals The inpatient, outpatient and social care costs associated with atrial fibrillation in Scotland: a record linkage study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Giorgio Ciminata ◽  
Olivia Wu ◽  
Claudia Geue
Keyword(s):  
Economic Burden ◽  
Social Care ◽  
Hospital Admissions ◽  
Healthcare Resource ◽  
Economic Status ◽  
Care Home ◽  
Individual Level ◽  
Socio Economic Status ◽  
The Cost ◽  
Care Costs

ABSTRACTBackgroundAtrial Fibrillation (AF) is a highly debilitating condition with significant economic burden. Previous studies have estimated the cost of hospitalisations associated with AF in Scotland. However, patients with AF are often elderly with co-morbidities requiring substantial outpatient and social care. ObjectivesThis study seeks to estimate inpatient, outpatient and social care costs associated with AF in a Scottish cohort, by using individual-level linked data. MethodsThe AF cohort of 50 years and older patients, hospitalised with a known diagnosis of AF or atrial flutter between 1997 and 2014, was followed up for five years following the first AF event. Individual-level data on hospitalisation and discharge to social care home were obtained from the Scottish Morbidity Records (SMR01); whereas data on outpatient attendance were obtained from (SMR00). Death records for the same time period were extracted from National Records of Scotland (NRS). Hospital and outpatient costs associated with the corresponding data were estimated utilising the Scottish National Tariff (SNT) based on Healthcare Resource Groups (HRGs), and the Scottish Health Service Costs report, respectively. Social care costs were identified from the Care Home Census. Following data linkage, the econometric analysis was carried out using a two-part model where, the first part estimates through a probit model the probability of using a healthcare service, and the second part estimates costs conditional on having incurred positive costs. The regression model was adjusted for demographic characteristics, socio-economic status, year of admission and location. ResultsOverall, a cohort of 253,963 AF patients accounted for 2,988,607 hospital admissions and 4,452,476 outpatient attendances. The mean cost per patient was estimated to be £3,071 (95% CI 3,033-3,109). Overall, hospital admissions and outpatient visits accounted for 71.7% and 3.7% of the total cost, respectively; social care accounted for 24.6% of the total costs. The cost increased with age and females incurred higher costs than males. Significant differences were observed among the urban/rural classifications, individual health boards and the socio-economic status. ConclusionsThis study has shown the importance of taking into account healthcare resource use incurred beyond hospitalisation. In addition to inpatient costs, outpatient and social care costs contribute considerably to the overall economic burden.

scholarly journals Mental, Physical and Socio-Economic Status of Adults Living in Spain during the Late Stages of the State of Emergency Caused by COVID-19

2022 ◽  
Vol 19 (2) ◽  
pp. 854
Author(s):  
Elisabet Sánchez-Rodríguez ◽  
Alexandra Ferreira-Valente ◽  
Filipa Pimenta ◽  
Antonella Ciaramella ◽  
Jordi Miró
Keyword(s):  
Online Survey ◽  
Negative Impact ◽  
Economic Status ◽  
Cross Sectional Study ◽  
The State ◽  
Negative Effects ◽  
Cross Sectional ◽  
State Of Emergency ◽  
Socio Economic Status ◽  
Late Stages

Research has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people’s lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.

scholarly journals 414 - Supporting staff delivering person-centered care to people with dementia in Dutch nursing homes

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra
Keyword(s):  
Nursing Homes ◽  
Living Arrangements ◽  
Online Survey ◽  
Dementia Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Modifiable Factors ◽  
Centered Care ◽  
Organizational Features

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.

scholarly journals A comparative study of dementia knowledge, attitudes and perception of  care approach among Chinese nursing and medical students

2020 ◽  
Author(s):  
Yao Wang ◽  
Lily Dongxia Xiao ◽  
Rong Huang
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Professional Education ◽  
Attitude Scale ◽  
Dementia Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
People With Dementia ◽  
Study Results ◽  
Care Approach

Abstract Background Dementia care requires inter-disciplinary collaboration starting from formal health professional education. Yet, little is known about how undergraduate medical and nursing students perceive dementia care in China. The aim of this study was to investigate undergraduate medical and nursing students’ knowledge, attitudes and care approach of dementia in China. Methods A cross-sectional survey was conducted. Students enrolled in a 5-year Bachelor of Medicine Program and a 4-year Bachelor of Nursing Program from four universities with campuses across Eastern, Western, Southern and Northern China were recruited into the study. Three validated instruments, Alzheimer’s Disease Knowledge Scale (AKDS), Dementia Care Attitude Scale (DCAS) and Approach to Advanced Dementia Care Questionnaire (ADCQ), were used to measure students’ dementia knowledge, attitudes and perceived care approach. Data were collected using a self-administered survey. Results The number of medical and nursing students completing the survey was 526 and 467 respectively. The overall mean score of students’ dementia knowledge measured by the ADKS was 19.49 (SD=2.82) out of 30, students’ attitudes to dementia was 29.92(SD=3.35) out of 40, and students’ person-centred care approach of dementia was 5.42 (SD=2.20) out of 13. Students’ overall knowledge towards dementia was poor and the attitudes were generally positive. Medical students demonstrated higher dementia knowledge scores and showed less positive attitude scores than nursing students (p<0.05). Students would not apply a person-centered care approach. There were no statistically significant differences in the mean scores of ADCQ between nursing students and medical students. Conclusions Study results highlight the urgent need to implement an inter-disciplinary approach to increasing dementia education among Chinese medical and nursing students, and ensuring that students have adequate knowledge, attitudes and experience in the care of people with dementia.

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