Costs of care trajectories of people with dementia compared with matched controls. Longitudinal analysis of linked health and administrative data

• Published in: International journal of geriatric psychiatry Vol. 39; no. 5; pp. e6094 - n/a
• Main Authors: Bosmans, Judith E., Heide, Iris, Hout, Hein P. J., Joling, Karlijn J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2024
• Subjects: administrative data; Aged; Aged, 80 and over; care trajectories; Case-Control Studies; Costs; Dementia; Dementia - economics; Dementia - therapy; Dementia disorders; Diagnosis; Electronic Health Records - statistics & numerical data; Electronic medical records; Female; Health Care Costs - statistics & numerical data; Home Care Services - economics; Home Care Services - statistics & numerical data; Humans; Institutionalization - economics; Institutionalization - statistics & numerical data; linked data; Long-Term Care - economics; Long-Term Care - statistics & numerical data; Longitudinal Studies; Male; Middle Aged; people with dementia; Primary care; costs; care trajectories; people with dementia; administrative data; linked data
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.6094

Objectives To provide insight into the health and social care costs during the disease trajectory in persons with dementia and the impact of institutionalization and death on healthcare costs compared with matched persons without dementia. Methods Electronic health record data from family physicians were linked with national administrative databases to estimate costs of primary care, medication, secondary care, mental care, home care and institutional care for people with dementia and matched persons from the year before the recorded dementia diagnosis until death or a maximum of 4 years after the diagnosis. Results Total mean health and social care costs among persons with dementia increased substantially during the disease trajectory, mainly due to institutional care costs. For people who remained living in the community, mean health and social care costs are higher for people with dementia than for those without dementia, while for those who are admitted to a long‐term care facility, mean health and social care costs are higher for people without dementia than for those with dementia. Conclusions The steep rise in health and social care costs across the dementia care trajectory is mainly due to increasing costs for institutional care. For those remaining in the community, home care costs and hospital care costs were the main cost drivers. Future research should adopt a societal perspective to investigate the influence of including social costs. Key points Health and social care costs among persons with dementia increase substantially during the disease trajectory. This steep rise in costs during the disease trajectory is mainly due to institutional care costs. For people who remained living in the community, mean health and social care costs are higher for people with dementia than for those without dementia. For people who are admitted to a long‐term care facility, mean health and social care costs are higher for people without dementia than for those with dementia.