Michalowsky Bernhard, Flessa Steffen, Hertel Johannes, Goetz Olav, Hoffmann Wolfgang, Teipel Stefan, Kilimann Ingo
Deutsches Zentrum fur Neurodegenerative Erkrankungen (DZNE) Standort Rostock/Greifswald, Greifswald, Germany.
Department of General Business Administration and Health Care Management, Ernst Moritz Arndt University Greifswald, Greifswald, D-17489, Germany.
Alzheimers Res Ther. 2017 Aug 22;9(1):65. doi: 10.1186/s13195-017-0290-6.
Little is known about diagnostic work-ups or the costs of diagnosing dementia in specialized care. Here, we analyzed the costs of diagnosing dementia according to specific dementia disorders.
A prospective descriptive design was used to analyze the cost of diagnosing dementia for 120 patients with suspected dementia at a German memory clinic. The duration of clinical consultations and use of technical procedures were recorded by the memory clinic staff. To detect cost drivers, a multiple linear regression model was used.
Of patients with suspected dementia, 44% were diagnosed with dementia. The total cost per patient and diagnostic process amounted to 501 € across all patients and 659 € for patients who were diagnosed with dementia. The costs varied between 649 € for patients with Alzheimer's disease, 662 € for patients with vascular or mixed dementia, and 705 € for patients with unspecific dementia. A final diagnosis of dementia was the only factor that was significantly associated with the diagnostic cost (b = 356, CI 182, CI 531, p = 0.001).
The high range of costs reflects differences in diagnostic demands depending on the etiology of dementia. This variation needs to be transferred into reimbursement. Further studies are needed to assess the influence of the type of cognitive impairment and of the setting on diagnostic costs.
关于专科护理中痴呆症的诊断检查或诊断成本知之甚少。在此,我们根据特定的痴呆症类型分析了痴呆症的诊断成本。
采用前瞻性描述性设计,分析德国一家记忆诊所120例疑似痴呆症患者的痴呆症诊断成本。记忆诊所工作人员记录临床咨询的持续时间和技术程序的使用情况。为了找出成本驱动因素,使用了多元线性回归模型。
在疑似痴呆症患者中,44%被诊断为痴呆症。所有患者的人均总成本和诊断过程为501欧元,被诊断为痴呆症的患者为659欧元。成本因痴呆症类型而异,阿尔茨海默病患者为649欧元,血管性或混合性痴呆患者为662欧元,非特异性痴呆患者为705欧元。痴呆症的最终诊断是与诊断成本显著相关的唯一因素(b = 356,CI 182,CI 531,p = 0.001)。
成本范围较高反映了根据痴呆症病因的诊断需求差异。这种差异需要转化为报销政策。需要进一步研究以评估认知障碍类型和诊断环境对诊断成本的影响。