Department of Epidemiology, National Institute of Mental Health and Neurosciences, Bangalore, India.
Indian J Public Health. 2013 Apr-Jun;57(2):71-7. doi: 10.4103/0019-557X.114986.
In 2010, nearly 37 lakh Indians have been estimated to be suffering from dementia. Estimated costs of care in published literature do not reflect the actual expenses of individual households. Hence, a household budget approach was undertaken to arrive at the costs of dementia care in India.
We identified and listed the different components of care, classified the applicability of care for the different components with respect to mild, moderate, and severe cases. This framework was utilized to assign costs of care and arrive at the household costs of care for a Person with Dementia (PwD) in both urban and rural areas.
The total expense was similar to that reported by individual households. The annual household cost of caring for a person with dementia in India, depending on the severity of the disease, ranged between INR 45,600 to INR 2,02,450 in urban areas and INR 20,300 to INR 66,025 in rural areas. Costs increased with increasing severity of the disease process. The costs of informal care contributed to nearly half of the total costs either in rural or urban area. With increasing severity, proportion of medical costs decreased while social cost increased. Medical costs in rural areas were nearly one-third of the total costs as against less than one-fifth in urban areas.
The household budget model realistically estimated the household costs of care. It is hoped that the comprehensive and generic framework would prompt health professionals, researchers, and policy makers in India to catalyze geriatric health services, particularly for care for PwD.
据估计，2010 年印度有近 370 万人患有痴呆症。已发表文献中的护理费用估计并未反映个别家庭的实际支出。因此，采用家庭预算法来计算印度痴呆症护理的费用。
我们确定并列出了护理的不同组成部分，根据轻度、中度和重度病例对护理的适用性进行了分类。利用这一框架对护理费用进行赋值，并计算出城市和农村地区每位痴呆症患者（PwD）的家庭护理费用。
总费用与个别家庭报告的费用相似。在印度，根据疾病的严重程度，每年照顾痴呆症患者的家庭费用在城市地区为 45600 印度卢比至 202450 印度卢比之间，在农村地区为 20300 印度卢比至 66025 印度卢比之间。费用随着疾病严重程度的增加而增加。非正式护理费用占总费用的近一半，无论是在农村还是城市地区。随着病情的加重，医疗费用在总费用中的比例下降，而社会成本增加。农村地区的医疗费用几乎占总费用的三分之一，而城市地区则不到五分之一。
家庭预算模型真实地估计了家庭护理费用。希望这一全面和通用的框架能够促使印度的卫生专业人员、研究人员和政策制定者推动老年保健服务，特别是为痴呆症患者提供护理。
