Cost of care for persons with dementia: using a discrete-time Markov chain approach with administrative and clinical data from the dementia service Centres in Austria

Abstract

Background There is growing evidence that the cost for dementia care will increase rapidly in the coming years. Therefore, the objective of this paper was to determine the economic impact of treating clients with dementia in outpatient Dementia Service Centres (DSCs) and simulate the cost progression with real clinical and cost data. Methods To estimate the cost for dementia care, real administrative and clinical data from 1341 clients of the DSCs were used to approximate the total cost of non-pharmaceutical treatment and simulate the cost progression with a discrete-time Markov chain (DTMC) model. The economic simulation model takes severity and progression of dementia into account to display the cost development over a period of up to ten years. Results Based on the administrative data, the total cost for treating these 1341 clients of the DSCs came to 67,294,910 EUR in the first year. From these costs, 74% occurred as indirect costs. Within a five-year period, these costs will increase by 7.1-fold (16.2-fold over 10 years). Further, the DTMC shows that the greatest share of the cost increase derives from the sharp increase of people with severe dementia and that the cost of severe dementia prevails the cost in later periods. Conclusion The DTMC model has shown that the cost increase of dementia care is mostly driven by the indirect cost and the increase of severity of dementia within any given year. The DTMC reveals also that the cost for mild dementia will decrease steadily over the time period of the simulation, whereas the cost for severe dementia increases sharply after running the simulation for 3 years.

The Costs of Dementia in Europe: An Updated Review and Meta-analysis

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Cost-utility analysis of a multispecialty interprofessional team dementia care model in Ontario, Canada

“…We have used a model-based approach to conduct the cost-effectiveness analysis for MINT Memory Clinic care; a similar approach has also been used to evaluate the cost of illness associated with dementia,32 33 and the cost-effectiveness of health interventions for people with dementia 31. Although no other studies have compared care models similar to MINT Memory Clinic care to usual dementia care services, cost-effectiveness of other dementia care interventions has been studied with positive results 30 31 34 35.…”

Nonpharmacological intervention therapies for dementia: potential break-even intervention price and savings for selected risk factors in the European healthcare system

“…Data sources were national studies [ 6 , 26 – 46 ], and therefore, they were further processed before use in the model. The first modification was to control for the different publication years.…”