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The European Journal of Health Economics
Published in: The European Journal of Health Economics 8/2015

01-11-2015 | Original Paper

Relationship between global severity of patients with Alzheimer’s disease and costs of care in Spain; results from the co-dependence study in Spain

Authors: J. Darbà, L. Kaskens, L. Lacey

Published in: The European Journal of Health Economics | Issue 8/2015

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Abstract

Objective

The objectives of this analysis were to examine how patients’ global severity with Alzheimer’s disease (AD) relates to costs of care and explore the incremental effects of global severity measured by the clinical dementia rating (CDR) scale on these costs for patients in Spain.

Methods

The Codep‐EA study is an 18-multicenter, cross-sectional, observational study among patients (343) with AD according to the CDR score and their caregivers in Spain. The data obtained included (in addition to clinical measures) also socio-demographic data concerning the patient and its caregiver. Cost analyses were based on resource use for medical care, social care, caregiver productivity losses, and informal caregiver time reported in the resource utilization in dementia (RUD). Lite instrument and a complementary questionnaire. Multivariate regression analysis was used to model the effects of global severity and other socio-demographic and clinical variables on cost of care.

Results

The mean (standard deviation) costs per patient over 6 months for direct medical, social care, indirect and informal care costs, were estimated at €1,028.1 (1,655.0), €843.8 (2,684.8), €464.2 (1,639.0) and €33,232.2 (30,898.9), respectively. Dementia severity, as having a CDR score 0.5, 2, or 3 with CDR score 1 being the reference group were all independently and significantly associated with informal care costs. Whereas having a CDR score of 2 was also significantly related with social care costs, a CDR score of 3 was associated with most cost components including direct medical, social care, and total costs, all compared to the reference group.

Conclusions

The costs of care for patients with AD in Spain are substantial, with informal care accounting for the greatest part. Dementia severity, measured by CDR score, showed that with increasing severity of the disease, direct medical, social care, informal care and total costs augmented.
Literature
1.
Reese, J.P., Hessmann, P., Seeberg, G., Henkel, D., Hirzmann, P., Rieke, J., et al.: Cost and care of patients with Alzheimer’s disease: clinical predictors in German health care settings. J. Alzheimers Dis. 27(4), 723–736 (2011). doi:10.​3233/​JAD-2011-110539 PubMed
2.
Fratiglioni, L., Launer, L.J., Andersen, K., Breteler, M.M., Copeland JR, Dartigues, J.F., et al.: Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic diseases in the Elderly Research Group. Neurology 54(11 Suppl. 5), S10–S15 (2000)PubMed
3.
4.
Boada, M., Peña-Casanova, J., Bermejo, F., Guillén, F., Hart, W.M., et al.: Coste de los recursos sanitarios de los pacientes en régimen ambulatorio diagnosticados de enfermedad de Alzheimer en España. Med Clin (Barc) 113, 690–695 (1999)
5.
6.
7.
Hebert, L.E., Scherr, P.A., Bienias, J.L., Bennett, D.A., Evans, D.A.: Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch. Neurol. 60, 1119–1122 (2003)CrossRefPubMed
8.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., Ferri, C.P.: The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer’s Dement. 9, 63–75 (2013)CrossRef
9.
Hux, M.J., O’Brien, B.J., Iskedjian, M., Goeree, R., Gagnon, M., Gauthier, S.: Relation between severity of Alzheimer’s disease and costs of caring. CMAJ 159(5), 457–465 (1998)PubMedCentralPubMed
10.
Mauskopf, J., Racketa, J., Sherrill, E.: Alzheimer’s disease: the strength of association of costs with different measures of disease severity. J. Nutr. Health Aging 14(8), 655–663 (2010)CrossRefPubMed
11.
Kronborg Andersen, C., Sogaard, J., Hansen, E., et al.: The cost of dementia in Denmark: the Odense Study. Dement. Geriatr. Cogn. Disord. 10(4), 295–304 (1999)CrossRefPubMed
12.
Leon, J., Neumann, P.J.: The cost of Alzheimer’s disease in managed care: a cross-sectional study. Am. J. Manag. Care 5(7), 867–877 (1999)PubMed
13.
Fillenbaum, G., Heyman, A., Peterson, B.L., Pieper, C.F., Weiman, A.L.: Use and cost of hospitalization of patients with AD by stage and living arrangement: CERAD XXI. Neurology a 56(2), 201–206 (2001)CrossRef
14.
Fillenbaum, G., Heyman, A., Peterson, B.L., Pieper, C.F., Weiman, A.L.: Use and cost of outpatient visits of AD patients: CERAD XXII. Neurology b 56(12), 1706–1711 (2001)CrossRef
15.
Sköldunger, A., Wimo, A., Johnell, K.: Net costs of dementia in Sweden—an incidence-based 10-year simulation study. Int. J. Geriatr. Psychiatry 27(11), 1112–1117 (2012). doi:10.​1002/​gps.​2828. Epub 2012 Feb 1CrossRefPubMed
16.
American Psychological Association (APA).: Diagnostic and statistical manual of mental disorders revised, vol. 4. American Psychiatric Press, Washington (1994)
17.
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., Stadlan, E.M.: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34(7), 939–944 (1984)CrossRefPubMed
18.
Morris, J.C.: The clinical dementia rating (CDR): current version and scoring rules. Neurology 43, 2412–2414 (1993)CrossRefPubMed
19.
Wimo, A.W., Winblad, B.: Resource utilization in dementia: RUD Lite. Brain Aging 3(1), 48–59 (2003)
20.
21.
Wimo, A., Jönsson, L., Bond, J., Prince, M., Winblad, B., Alzheimer Disease International: The worldwide economic impact of dementia 2010. Alzheimers Dement. 9(1), 1.e3–11.e3 (2013)CrossRef
22.
Berg, L.: Clinical dementia rating (CDR). Psychopharmacol. Bull. 24, 637–639 (1988)PubMed
23.
Hughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., Martin, R.L.: A new clinical scale for the staging of dementia. Br. J. Psychiatry 140, 566–572 (1982)CrossRefPubMed
24.
Morris, J.C.: The clinical dementia rating (CDR): current version and scoring rules. Neurology 43, 2412–2414 (1993)CrossRefPubMed
25.
Salvi, F., Miller, M.D., Grilli, A., Giorgi, R., Towers, A.L., Morichi, V., et al.: A manual of guidelines to score the modified cumulative illness rating scale and its validation in acute hospitalized elderly patients. J. Am. Geriatr. Soc. 56(10), 1926–1931 (2008)CrossRefPubMed
26.
Corder, L.S., Woodbury, M.A., Manton, K.G.: Proxy response patterns among the aged: effects on estimates of health status and medical care utilization from the 1982-1984 long-term care surveys. J. Clin. Epidemiol. 49, 173–182 (1996)CrossRefPubMed
27.
Neumann, P.J., Araki, S.S., Gutterman, E.M.: The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J. Am. Geriatr. Soc. 48, 1646–1654 (2000)CrossRefPubMed
28.
McDaid, D.: Estimating the costs of informal care for people with Alzheimer’s disease: methodological and practical challenges. Int. J. Geriatr. Psychiatry 16, 400–405 (2001)CrossRefPubMed
29.
Karlsson, G., Jonsson, B., Wimo, A., Winblad, B.: Methodological issues in health economics of dementia. In: Wimo, A., Jonsson, B., Karlsson, G., Winblad, B. (eds.) Health economics of dementia, pp. 161–169. Wiley, London (1998)
30.
Hospital Zamora, Zamora, Castilla and Léon (2011)
31.
Hospital Santiago de Compostela, Santiago de Compostela, Galicia (2011)
32.
33.
34.
Hospital Padre Menni, Santander, Cantabria (2011)
35.
Hospital Santa Caterina, Girona, Catalonia (2012)
36.
37.
38.
Instituto Andaluz de Neurociencia, Málaga (2011)
39.
40.
41.
Metadata
Title
Relationship between global severity of patients with Alzheimer’s disease and costs of care in Spain; results from the co-dependence study in Spain
Authors
J. Darbà
L. Kaskens
L. Lacey
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 8/2015
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-014-0642-0

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