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Societal and Family Lifetime Cost of Dementia: Implications for Policy.

ABSTRACT: OBJECTIVES:To estimate the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia. DESIGN:We developed an evidence-based mathematical model to simulate disease progression for newly diagnosed individuals with dementia. Data-driven trajectories of cognition, function, and behavioral and psychological symptoms were used to model disease progression and predict costs. Using modeling, we evaluated lifetime and annual costs of individuals with dementia, compared costs of those with and without clinical features of dementia, and evaluated the effect of reducing functional decline or behavioral and psychological symptoms by 10% for 12 months (implemented when Mini-Mental State Examination score ?21). SETTING:Mathematical model. PARTICIPANTS:Representative simulated U.S. incident dementia cases. MEASUREMENTS:Value of informal care, out-of-pocket expenditures, Medicaid expenditures, and Medicare expenditures. RESULTS:From time of diagnosis (mean age 83), discounted total lifetime cost of care for a person with dementia was $321,780 (2015 dollars). Families incurred 70% of the total cost burden ($225,140), Medicaid accounted for 14% ($44,090), and Medicare accounted for 16% ($52,540). Costs for a person with dementia over a lifetime were $184,500 greater (86% incurred by families) than for someone without dementia. Total annual cost peaked at $89,000, and net cost peaked at $72,400. Reducing functional decline or behavioral and psychological symptoms by 10% resulted in $3,880 and $680 lower lifetime costs than natural disease progression. CONCLUSION:Dementia substantially increases lifetime costs of care. Long-lasting, effective interventions are needed to support families because they incur the most dementia cost.

SUBMITTER: Jutkowitz E

PROVIDER: S-EPMC5657516 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Societal and Family Lifetime Cost of Dementia: Implications for Policy.

Jutkowitz Eric E Kane Robert L RL Gaugler Joseph E JE MacLehose Richard F RF Dowd Bryan B Kuntz Karen M KM

Journal of the American Geriatrics Society 20170817 10

<h4>Objectives</h4>To estimate the cost of dementia and the extra cost of caring for someone with dementia over the cost of caring for someone without dementia.<h4>Design</h4>We developed an evidence-based mathematical model to simulate disease progression for newly diagnosed individuals with dementia. Data-driven trajectories of cognition, function, and behavioral and psychological symptoms were used to model disease progression and predict costs. Using modeling, we evaluated lifetime and annua ...[more]

PMID: 28815557

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Project description:ObjectivesWhile the costs and outcomes of cochlear implantation (CI) have been widely assessed, most of these analyses were solely performed from the perspective of healthcare costs. This study assesses the costs and benefits of CI in the Netherlands from a broader societal perspective, including health outcomes, healthcare cost, educational cost, and productivity losses and gains.DesignThe cost and benefits of CI were analyzed in this cost-benefit analysis, in which a monetary value is put on both the resources needed and the outcomes of CI. The costs and benefits were analyzed by prototypical instances of three groups, representing the majority of cochlear implant patients: prelingually deaf children implanted at the age of 1, adults with progressive profound hearing loss implanted at the age of 40 and seniors implanted at the age of 70 with progressive profound hearing loss. Costs and benefits were estimated over the expected lifetimes of the members of each group, using a Markov state transition model. Model parameters and assumptions were based on published literature. Probabilistic and one-way sensitivity analyses were performed.ResultsIn all three patient groups, the total benefits of CI exceeded the total cost, leading to a net benefit of CI. Prelingually deaf children with a bilateral CI had a lifetime positive outcome net benefit of €433,000. Adults and seniors with progressive profound hearing loss and a unilateral CI had a total net benefit of €275,000 and €76,000, respectively. These results ensue from health outcomes expressed in monetary terms, reduced educational cost, and increased productivity.ConclusionsBased on estimates from modeling, the increased healthcare costs due to CI were more than compensated by the value of the health benefits and by savings in educational and productivity costs. In particular, for children and working adults, the societal benefit was positive even without taking health benefits into account. Therefore, CI generates an advantage for both patients and society.

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Dataset Information

Societal and Family Lifetime Cost of Dementia: Implications for Policy.

Publications

Societal and Family Lifetime Cost of Dementia: Implications for Policy.

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