Cost of care of Agitation and Agression associated to dementia in 8 European Countries: results from the Right Time Place Care (RTPC) study
OBJECTIVES Dementia is associated with high costs of national healthcare in European countries. Disruptive neuropsychiatric symptom (NPS) such as agitation and aggression (A/A), increase caregiver burden, lead to premature institutionalization and death, and increase dementia costs. The aim of this study is to estimate the incremental societal costs for Patients with Dementia (PwD) with A/A in both Community-Dwelling (CD) and long-term care (LTC) settings in 8 European countries. METHODS This study uses data fromthe RightTimePlaceCare (RTPC) European project. Interviews using structured questionnaires are conducted with 2014 PwD and their primary informal caregivers. Direct and informal costs are estimated from a societal perspective. Resource utilization is assessed with the resource utilization in dementia instrument. Resource consumption is valued using unit costs for each country, the replacement cost approach (informal care) and retail prices (medication).To estimate incremental costs of A/A, costs for PwD with A/A are compared to costs for PwD without A/A in both settings. Special emphasis is placed on the main predictors of costs. RESULTS 2002 patients completed agitation item into the NeuroPsychiatric Inventory-Questionnaire at baseline (i.e. 1219 CD and 883 LTC). For CD patients with A/A societal costs are 2,472€ for one month vs. 2,144€ for patient without A/A (p=0.002). Incremental costs of A/A for CD patients are mainly due to informal costs and inpatient costs which are+174€ (p=0.015) and +113€ (p=0.048), respectively. For LTC patients with A/A societal costs are 4,730€ for one month vs. 4,166€ for patients without A/A (p=0.003). Incremental costs of A/A for LTC patients are mainly due to nursing home costs and outpatient costs which are +353€ (p=0.003) and +148€ (p=0.000), respectively. CONCLUSIONS A/A in PwD living at home or in LTC setting increase societal costs by 15%.
Costa, N., A. Wübker, I. Binot, A. De Mauléon, S. Zwakhalen, D. Challis, M. Stolt, A. Stephan, A. Zabalegui, K. Saks, B. Vellas, L. Molinier, D. Sauerland und M. Soto (2015), Cost of care of Agitation and Agression associated to dementia in 8 European Countries: results from the Right Time Place Care (RTPC) study. Value in Health, 18, 3, A118