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

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

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cooperative Behavior*
  • Cost-Benefit Analysis / statistics & numerical data*
  • Dementia / therapy*
  • Disease Management*
  • Female
  • Humans
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data
  • Quality-Adjusted Life Years*
  • Surveys and Questionnaires