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Cited by 22Dementia and Cognitive Impairment ResearchHealth Systems, Economic Evaluations, Quality of LifeGeriatric Care and Nursing Homes

Cost effectiveness of non‐drug interventions that reduce nursing home admissions for people living with dementia

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Jutkowitz, Eric, Pizzi, Laura T., Shewmaker, Peter, Alarid‐Escudero, Fernando, Epstein‐Lubow, Gary, Prioli, Katherine M., Gaugler, Joseph E., Gitlin, Laura N.·2023·Alzheimer's & Dementia
DOI 10.1002/alz.12964PMC PMC10524701
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Abstract

INTRODUCTION: Six million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health‐care cost driver. We evaluated the cost effectiveness of non‐pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD. METHODS: We used a person‐level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence‐based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer's and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality‐adjusted life years and incremental cost‐effectiveness ratios. RESULTS: All four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1‐way, 2‐way, structural, and probabilistic sensitivity analyses. CONCLUSION: Dementia‐care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non‐pharmacologic interventions.

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  • Individual studies of care coordination have shown reduced care home admission and cost-effectiveness from a societal and individual perspective, but a meta-analysis of 14 care coordination RCTs did not show a statistically significant reduction in care home admission or hospitalisation.

    “Individual studies of care coordination have shown reduced care home admission, and cost-effectiveness from a societal and individual perspective,(479) but a meta-analysis of 14 care coordination RCTs did not show a statistically significant reduction in care home admission or hospitalisation. (478)”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [479]

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Authors
Jutkowitz, E., Pizzi, L. T., Shewmaker, P., Alarid‐Escudero, F., Epstein‐Lubow, G., Prioli, K. M., Gaugler, J. E., & Gitlin, L. N.
Affiliations
  • Brown University (US)
  • Rutgers, The State University of New Jersey (US)
  • Stanford University (US)
  • Department of Health Services, Policy & Practice Brown University School of Public Health Providence Rhode Island USA
  • University of Minnesota (US)
  • Drexel University (US)
Corresponding author
Jutkowitz, Eric
ORCID
Venue
Alzheimer's & Dementia
Publisher
Wiley
Published
2023-04-06
Volume
19
Issue
9
Pages
3867-3893
ISSN
  • 1552-5260 (ISSN-L)
  • 1552-5279
DOI
10.1002/alz.12964
PMC
PMC10524701
OpenAlex
W4362657255
Cited by
22
References
3
Citations by year
2026: 6 · 2025: 11 · 2024: 3 · 2023: 2
FWCI
4.48
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alzheimer s & Dementia (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (1R21AG059623‐01, 1R01AG060871‐01, 1RF1AG069771, R01 AG049692)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
dementia, Alzheimer's disease and related dementias
MeSH terms
Cost-Effectiveness Analysis, Adult, Alzheimer Disease, Cost-Benefit Analysis, Humans, Nursing Homes, Caregivers

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