Department of Rehabilitation, Aged and Extended Care, Flinders University, Bedford Park, SA, Australia.
NHMRC Cognitive Decline Partnership Centre, The University of Sydney, Sydney, NSW, Australia.
Int J Geriatr Psychiatry. 2018 Jul;33(7):859-866. doi: 10.1002/gps.4842. Epub 2018 Jan 2.
This analysis estimates the whole-of-system direct costs for people living with dementia in residential care by using a broad health and social care provision perspective and compares it to people without dementia living in residential care.
Data were collected from 541 individuals living permanently in 17 care facilities across Australia. The annual cost of health and residential care was determined by using individual resource use data and reported by the dementia status of the individuals.
The average annual whole-of-system cost for people living with dementia in residential care was approximately AU$88 000 (US$ 67 100) per person in 2016. The cost of residential care constituted 93% of the total costs. The direct health care costs were comprised mainly of hospital admissions (48%), pharmaceuticals (31%) and out-of-hospital attendances (15%). While total costs were not significantly different between those with and without dementia, the cost of residential care was significantly higher and the cost of health care was significantly lower for people living with dementia.
This study provides the first estimate of the whole-of-system costs of providing health and residential care for people living with dementia in residential aged care in Australia using individual level health and social care data. This predominantly bottom-up cost estimate indicates the high cost associated with caring for people with dementia living permanently in residential care, which is underestimated when limited cost perspectives or top-down, population costing approaches are taken.
本分析从广泛的医疗和社会保健服务角度出发，估算了居住在养老院中的痴呆症患者的全系统直接成本，并将其与居住在养老院中的非痴呆症患者进行了比较。
数据来自澳大利亚 17 家护理机构的 541 名永久性居住者。根据个人资源使用数据确定了健康和养老院护理的年度成本，并报告了个人的痴呆症状况。
2016 年，居住在养老院中的痴呆症患者的全系统平均年总成本约为每人 88000 澳元（67100 美元）。养老院护理费用占总费用的 93%。直接医疗保健费用主要由住院治疗（48%）、药品（31%）和院外就诊（15%）构成。虽然痴呆症患者和非痴呆症患者的总费用没有显著差异，但痴呆症患者的养老院护理费用明显更高，而医疗保健费用明显更低。
本研究首次使用个人健康和社会保健数据，对澳大利亚养老院中为痴呆症患者提供健康和养老院护理的全系统成本进行了估算。这种主要基于底层的成本估算表明，永久性居住在养老院中的痴呆症患者的护理成本很高，而采用有限的成本视角或自上而下的人口成本方法时，这一成本被低估了。
