Predictors of high hospital care and medication costs and cost trajectories in community-dwellers with Alzheimer's disease
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CitationKalamägi, J. Lavikainen, P. Taipale, H. Tanskanen, A. Tiihonen, J. Hartikainen, S. Tolppanen, AM. (2019). Predictors of high hospital care and medication costs and cost trajectories in community-dwellers with Alzheimer's disease. Annals of medicine, 51 (5-6) , 294-305. 10.1080/07853890.2019.1642507.
Objectives: We studied the determinants of high healthcare costs (highest decile of hospital care and medication costs) and cost trajectories among all community-dwellers with clinically verified Alzheimer’s disease (AD), diagnosed during 2005–2011 in Finland (N = 70,531).
Methods: The analyses were done separately for hospital care costs, medication costs and total healthcare costs that were calculated for each 6-month period from 5 years before to 3 years after AD diagnosis.
Results: Total healthcare costs were driven mainly by hospital care costs. The definition of “high-cost person” was time-dependent as 63% belonged to the highest 10% at some timepoint during the study period and six distinct cost trajectories were identified. Strokes, cardiovascular diseases, fractures and mental and behavioural disorders were most strongly associated with high hospital care costs.
Conclusions: Although persons with AD are often collectively considered as expensive patient group, there is large temporal and inter-individual variation in belonging to the highest decile of hospitalization and/or medication costs. It would be important to assess whether hospitalization rate could be decreased by, e.g., comprehensive outpatient care with more efficient management of comorbidities. In addition, other interventions that could decrease hospitalization rate in persons with dementia should be studied further in this context.