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Alzheimers Dement. 2019 Oct;15(10):1296-1308. doi: 10.1016/j.jalz.2019.05.008. Epub 2019 Aug 10.

Cost-effectiveness of a collaborative dementia care management-Results of a cluster-randomized controlled trial.

Author information

1
German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada. Electronic address: bernhard.michalowsky@dzne.de.
2
Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada; Program for Health Economics and Outcome Measures (PHENOM), Hamilton, Canada.
3
German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany.
4
German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
5
Department of Psychosomatic Medicine, University Hospital Rostock, Rostock, Germany; German Centre for Neurodegenerative Diseases (DZNE), Rostock, Germany.
6
German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany; Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany.

Abstract

INTRODUCTION:

The purpose of this study was to determine the cost-effectiveness of collaborative dementia care management (DCM).

METHODS:

The cost-effectiveness analysis was based on the data of 444 patients of a cluster-randomized, controlled trial, conceptualized to evaluate a collaborative DCM that aimed to optimize treatment and care in dementia. Health-care resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were measured over a 24-month time horizon.

RESULTS:

DCM increased QALYs (+0.05) and decreased costs (-569€) due to a lower hospitalization and a delayed institutionalization (7 months) compared with usual care. The probability of DCM being cost-effective was 88% at willingness-to-pay thresholds of 40,000€ per QALY gained and higher in patients living alone compared to those not living alone (96% vs. 26%).

DISCUSSION:

DCM is likely to be a cost-effective strategy in treating dementia and thus beneficial for public health-care payers and patients, especially for those living alone.

KEYWORDS:

Alzheimer's disease; Collaborative care; Cost-effectiveness; Costs; Dementia; Dementia care management; Economic impact; Economics; Formal care; Informal care; Medical treatment; Nonmedical treatment

PMID:
31409541
DOI:
10.1016/j.jalz.2019.05.008
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