The main cost drivers in dementia: a systematic review: Systematic review of COI studies in dementia focusing on care settings
Abstract
OBJECTIVES: Because of the increasing prevalence of dementia worldwide, combined with limited healthcare expenditures, a better understanding of the main cost drivers of dementia in different care settings is needed. METHODS: A systematic review of cost-of-illness (COI) studies in dementia was conducted from 2003 to 2012, searching the following databases: PubMed (Medline), Cochrane Library, ScienceDirect (Embase) and National Health Service Economic Evaluations Database. Costs (per patient) by care setting were analyzed for total, direct, indirect and informal costs and related to the following: (1) cost perspective and (2) disease severity. RESULTS: In total, 27 studies from 14 different healthcare systems were evaluated. In the included studies, total annual costs for dementia of up to $70,911 per patient (mixed setting) were estimated (average estimate of total costs = $30,554). The shares of cost categories in the total costs for dementia indicate significant differences for different care settings. Overall main cost drivers of dementia are informal costs due to home based long term care and nursing home expenditures rather than direct medical costs (inpatient and outpatient services, medication). CONCLUSIONS: The results of this review highlight the significant economic burden of dementia for patients, families and healthcare systems and thus are important for future health policy planning. The significant variation of cost estimates for different care settings underlines the need to understand and address the financial burden of dementia from both perspectives. For health policy planning in dementia, future COI studies should follow a quality standard protocol with clearly defined cost components and separate estimates by care setting and disease severity.
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Informal costs are the main cost drivers at 60 to 84%, followed by medication costs and direct non-medical costs.
“Data suggests informal costs (amount of informal caregiver’s time provided for care) are the main cost drivers at 60 to 84%, followed by medication costs and direct non-medical costs (paid help or transport) [53].”
From Towards defining quality in home care for persons living with dementia (2022) · cites this paper as [53]
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- Authors
- Schaller, S., Mauskopf, J., Kriza, C., Wahlster, P., & Kolominsky-Rabas, P. L.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- RTI Health Solutions (US)
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health; Friedrich-Alexander-University Erlangen-Nürnberg; Erlangen Germany
- Corresponding author
- Schaller, Sandra
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2014-10-16
- Volume
- 30
- Issue
- 2
- Pages
- 111-129
- ISSN
- 0885-6230 (ISSN-L)
- OpenAlex
- W1780318505
- Cited by
- 215
- References
- 62
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 23 · 2023: 14 · 2022: 24 · 2021: 27 · 2020: 17 · 2019: 16 · 2018: 14 · 2017: 16 · 2016: 22 · 2015: 14
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission (ICT FP7, project ID 287509)
- 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 › Global Health Care Issues
- Keywords
- dementia, economic burden, cost drivers, informal care costs, home-based long-term care, nursing home costs, direct medical costs, indirect costs, disease severity, care environment, economic burden of dementia, health policy
- MeSH terms
- Delivery of Health Care, Dementia, Humans, Mental Health Services, Health Care Costs, Cost of Illness
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