Costs of Care of Agitation Associated With Dementia in 8 European Countries: Results From the RightTimePlaceCare Study

Research output: Contribution to journalArticle

Abstract

Objective To estimate the additional societal costs for people living with dementia (PwD) with agitation in home care (HC) and institutional long-term care (ILTC) settings in 8 European countries. Design Cross-sectional data from the RightTimePlaceCare cohort. Setting HC and ILTC settings from 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, and England). Participants A total of 1997 PwD (1217 in HC group and 780 lived in an ILTC) and their caregivers. Main Outcome Measures Medical care, community care, and informal care were recorded using the Resource Utilization in Dementia (RUD) questionnaire. Agitation was assessed based on the agitation symptoms cluster defined by the presence of agitation and/or irritability and/or disinhibition and/or aberrant motor behavior items of the Neuropsychiatric Inventory Questionnaire (NPI-Q). Results Total monthly mean cost differences due to agitation were 445€ in the HC setting and 561€ in the ILTC setting (P =.01 and.02, respectively). Informal care costs were the main driver in the HC group (73% of total costs) and institutional care costs were the main driver in the ILTC group (53% of total costs). After adjustments, the log link generalized linear mixed model showed an association between agitation symptoms and an increase of informal care costs by 17% per month in HC setting (P <.05). Conclusion This study found that agitation symptoms have a substantial impact on informal care costs in the community care setting. Future research is needed to evaluate which strategies may be efficient by improving the cost-effectiveness ratio and reducing the burden associated with informal care in the management of agitation in PwD.

Details

Authors
  • Nadège Costa
  • Ansgar Wübker
  • Adelaïde De Mauléon
  • Sandra M.G. Zwakhalen
  • David Challis
  • Helena Leino-Kilpi
  • Ingalill Rahm Hallberg
  • Astrid Stephan
  • Adelaida Zabalegui
  • Kai Saks
  • Laurent Molinier
  • Anders Wimo
  • Bruno Vellas
  • Dirk Sauerland
  • Ingrid Binot
  • Maria E. Soto
  • RightTimePlaceCare consortium
Organisations
External organisations
  • Toulouse University Hospital
  • University of Toulouse
  • Karolinska Institutet
  • Rheinisch-Westfälisches Institut für Wirtschaftsforschung
  • Maastricht University
  • University of Manchester
  • University of Turku
  • Witten/Herdecke University
  • Hospital Clínic of Barcelona
  • University of Tartu
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • agitation, costs, Dementia, Europe, informal care, long-term care
Original languageEnglish
Pages (from-to)95.e1-95.e10
JournalJournal of the American Medical Directors Association
Volume19
Issue number1
Publication statusPublished - 2018
Publication categoryResearch
Peer-reviewedYes