Abstract
Objective
To estimate the additional societal costs for people living with dementia (PwD) with
agitation in home care (HC) and institutional long-term care (ILTC) settings in 8
European countries.
Design
Cross-sectional data from the RightTimePlaceCare cohort.
Setting
HC and ILTC settings from 8 European countries (Estonia, Finland, France, Germany,
Netherlands, Spain, Sweden, and England).
Participants
A total of 1997 PwD (1217 in HC group and 780 lived in an ILTC) and their caregivers.
Main Outcome Measures
Medical care, community care, and informal care were recorded using the Resource Utilization
in Dementia (RUD) questionnaire. Agitation was assessed based on the agitation symptoms
cluster defined by the presence of agitation and/or irritability and/or disinhibition
and/or aberrant motor behavior items of the Neuropsychiatric Inventory Questionnaire
(NPI-Q).
Results
Total monthly mean cost differences due to agitation were 445€ in the HC setting and
561€ in the ILTC setting (P = .01 and .02, respectively). Informal care costs were the main driver in the HC
group (73% of total costs) and institutional care costs were the main driver in the
ILTC group (53% of total costs). After adjustments, the log link generalized linear
mixed model showed an association between agitation symptoms and an increase of informal
care costs by 17% per month in HC setting (P < .05).
Conclusion
This study found that agitation symptoms have a substantial impact on informal care
costs in the community care setting. Future research is needed to evaluate which strategies
may be efficient by improving the cost-effectiveness ratio and reducing the burden
associated with informal care in the management of agitation in PwD.
Keywords
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Article info
Footnotes
See Appendix 1 for members of the RightTimePlaceCare consortium.
The authors declare no conflicts of interest.
The RightTimePlaceCare study is supported by a grant from the European Commission within the 7th framework programme (project 242153).
Data sharing: RightTimePlacecare data, protocols, and other metadata are available to the scientific community.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
