Rehabilitation, Aged and Extended Care, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Threshold Economics Ltd, Auckland, New Zealand.
Australas J Ageing. 2020 Dec;39(4):e506-e514. doi: 10.1111/ajag.12818. Epub 2020 Jul 1.
To model the potential financial implications of Australian programs supporting cognitively impaired community-dwelling older people.
Markov cohort models of (a) an observational study of a residential dyadic training program for carers and people with dementia (GTSAH) and (b) a frailty intervention (FIT) in a cognitively impaired subgroup. Direct health and social welfare costs accrued over 5 years (2018 $AUD prices) were captured. GTSAH costs $3755, FIT costs $1834, and permanent residential aged care (P-RAC) costs $237 per day.
Modelling predicted costs break even in approximately 5 months for GTSAH and 7 months for FIT, after which these interventions saved funds. The primary driver of savings was the P-RAC cost (discounted at 5%/annum), at $121 030 for GTSAH vs $231 193 for standard care; and $47 857 with FIT vs $111 359 for standard care.
Programs supporting cognitively impaired community-dwelling older people could be financially beneficial; further evaluation and implementation would be a worthwhile investment.
建立澳大利亚支持认知障碍的社区居住老年人项目的潜在经济影响模型。
采用马尔可夫队列模型，对（a）一项针对护理人员和痴呆症患者的住宅双训练计划（GTSAH）的观察性研究，以及（b）一项认知障碍亚组的脆弱性干预（FIT）进行建模。直接的健康和社会福利成本在 5 年内（2018 澳元价格）累计。GTSAH 的成本为 3755 澳元，FIT 的成本为 1834 澳元，而永久性养老院（P-RAC）的费用为每天 237 澳元。
模型预测，GTSAH 在大约 5 个月后达到成本平衡，FIT 在大约 7 个月后达到成本平衡，之后这些干预措施开始节省资金。节省的主要驱动因素是养老院（按 5%/年贴现）的费用，GTSAH 为 121030 澳元，而标准护理为 231193 澳元；FIT 为 47857 澳元，而标准护理为 111359 澳元。
支持认知障碍的社区居住老年人的项目可能具有经济效益；进一步的评估和实施将是一项值得的投资。
