Skip to main content
Erschienen in: The European Journal of Health Economics 1/2018

03.02.2017 | Original Paper

Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial

verfasst von: Bernhard Michalowsky, Steffen Flessa, Tilly Eichler, Johannes Hertel, Adina Dreier, Ina Zwingmann, Diana Wucherer, Henriette Rau, Jochen René Thyrian, Wolfgang Hoffmann

Erschienen in: The European Journal of Health Economics | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

The objectives of this cross-sectional analysis were to determine healthcare resource utilization and cost for community-dwelling patients with dementia (PWD) from a payer’s and societal perspective, and to analyze the associations between costs and sociodemographic and clinical variables. Analysis of healthcare costs from a payer’s perspective was based on a sample of 425 PWD, analysis of healthcare costs from societal perspective on a subsample of 254 PWD and their informal caregivers. Frequency of healthcare resource utilization was assessed by means of questionnaires. Informal care and productivity losses were assessed by using the Resource Utilization in Dementia questionnaire (RUD). Costs were monetarized using standardized unit costs. To analyze the associations, multiple linear regression models were used. Total annual costs per PWD valued 7016€ from a payer’s and 25,877€ from a societal perspective, meaning that societal cost is approximately three and a half times as much as payer’s expenditures. Costs valuated 5456 € for medical treatments, 1559 € for formal care, 18,327€ for informal care. Productivity losses valued 1297€ for PWD caregivers. Informal care could vary substantially (−21%; +33%) concerning different valuation methods. Medical care costs decreased significantly with progression of dementia and with age. Costs of care double over the stages of dementia. Formal care costs were significantly higher for PWD living alone and informal care costs significantly lower for PWD with an employed caregiver. For all cost categories, deficits in daily living activities were major cost drivers.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Exchange rate: 1€ = $1.06763 (November 2015).
 
Literatur
1.
Zurück zum Zitat Fendrich, K., Hoffmann, W.: More than just aging societies: the demographic change has an impact on actual numbers of patients. J Public Health 15(5), 345–351 (2007)CrossRef Fendrich, K., Hoffmann, W.: More than just aging societies: the demographic change has an impact on actual numbers of patients. J Public Health 15(5), 345–351 (2007)CrossRef
2.
Zurück zum Zitat Prince, M., Wimo, A., Guerchet, M., Ali, G-C., Wu, Y-T., Prina, M.: World Alzheimer Report 2015. The Global Impact of Dementia. An analysis of prevalence, incidence, costs and trends. World Alzheimer Report. London, Alzheimer´s Diseases International. (2015) Prince, M., Wimo, A., Guerchet, M., Ali, G-C., Wu, Y-T., Prina, M.: World Alzheimer Report 2015. The Global Impact of Dementia. An analysis of prevalence, incidence, costs and trends. World Alzheimer Report. London, Alzheimer´s Diseases International. (2015)
4.
Zurück zum Zitat Grass-Kapanke, B., Kunczik, T., Gutzmann, H.: Studie zur Demenzversorgung im ambulanten Sektor-DIAS. In: vol. Demenzversorgung im ambulanten Sektor-DIAS. (2008) Grass-Kapanke, B., Kunczik, T., Gutzmann, H.: Studie zur Demenzversorgung im ambulanten Sektor-DIAS. In: vol. Demenzversorgung im ambulanten Sektor-DIAS. (2008)
5.
Zurück zum Zitat Quentin, W., Riedel-Heller, S.G., Luppa, M., Rudolph, A., Konig, H.H.: Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatr Scand 121(4), 243–259 (2010)CrossRef Quentin, W., Riedel-Heller, S.G., Luppa, M., Rudolph, A., Konig, H.H.: Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatr Scand 121(4), 243–259 (2010)CrossRef
6.
Zurück zum Zitat Lopez-Bastida, J., Serrano-Aguilar, P., Perestelo-Perez, L., Oliva-Moreno, J.: Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. Neurology 67(12), 2186–2191 (2006)CrossRef Lopez-Bastida, J., Serrano-Aguilar, P., Perestelo-Perez, L., Oliva-Moreno, J.: Social-economic costs and quality of life of Alzheimer disease in the Canary Islands, Spain. Neurology 67(12), 2186–2191 (2006)CrossRef
7.
Zurück zum Zitat Boada, M., Pena-Casanova, J., Bermejo, F., Guillen, F., Hart, W.M., Espinosa, C., Rovira, J.: Costs of health care resources of ambulatory-care patients diagnosed with Alzheimer’s disease in Spain. Med Clin 113(18), 690–695 (1999) Boada, M., Pena-Casanova, J., Bermejo, F., Guillen, F., Hart, W.M., Espinosa, C., Rovira, J.: Costs of health care resources of ambulatory-care patients diagnosed with Alzheimer’s disease in Spain. Med Clin 113(18), 690–695 (1999)
8.
Zurück zum Zitat Leon, J., Cheng, C.K., Neumann, P.J.: Alzheimer’s disease care: costs and potential savings. Health Aff 17(6), 206–216 (1998)CrossRef Leon, J., Cheng, C.K., Neumann, P.J.: Alzheimer’s disease care: costs and potential savings. Health Aff 17(6), 206–216 (1998)CrossRef
9.
Zurück zum Zitat Leon, J., Neumann, P.J.: The cost of Alzheimer’s disease in managed care: a cross-sectional study. Am J Manag Care 5(7), 867–877 (1999)PubMed Leon, J., Neumann, P.J.: The cost of Alzheimer’s disease in managed care: a cross-sectional study. Am J Manag Care 5(7), 867–877 (1999)PubMed
10.
Zurück zum Zitat Taylor Jr, D.H., Schenkman, M., Zhou, J., Sloan, F.A.: The relative effect of Alzheimer’s disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol Series B Psychol Sci Soc Sci 56(5), S285–293 (2001)CrossRef Taylor Jr, D.H., Schenkman, M., Zhou, J., Sloan, F.A.: The relative effect of Alzheimer’s disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol Series B Psychol Sci Soc Sci 56(5), S285–293 (2001)CrossRef
11.
Zurück zum Zitat Rigaud, A.S., Fagnani, F., Bayle, C., Latour, F., Traykov, L., Forette, F.: Patients with Alzheimer’s disease living at home in France: costs and consequences of the disease. J Geriatr Psychiatry Neurol 16(3), 140–145 (2003)CrossRef Rigaud, A.S., Fagnani, F., Bayle, C., Latour, F., Traykov, L., Forette, F.: Patients with Alzheimer’s disease living at home in France: costs and consequences of the disease. J Geriatr Psychiatry Neurol 16(3), 140–145 (2003)CrossRef
12.
Zurück zum Zitat Schwarzkopf, L., Menn, P., Kunz, S., Holle, R., Lauterberg, J., Marx, P., Mehlig, H., Wunder, S., Leidl, R., Donath, C., Graessel, E.: Costs of care for dementia patients in community setting: an analysis for mild and moderate disease stage. Value Health 14(6), 827–835 (2011)CrossRef Schwarzkopf, L., Menn, P., Kunz, S., Holle, R., Lauterberg, J., Marx, P., Mehlig, H., Wunder, S., Leidl, R., Donath, C., Graessel, E.: Costs of care for dementia patients in community setting: an analysis for mild and moderate disease stage. Value Health 14(6), 827–835 (2011)CrossRef
13.
Zurück zum Zitat König, H.H., Leicht, H., Brettschneider, C., Bachmann, C., Bickel, H., Fuchs, A., Jessen, F., Kohler, M., Luppa, M., Mosch, E., Pentzek, M., Werle, J., Weyerer, S., Wiese, B., Scherer, M., Maier, W., Riedel-Heller, S.G.: The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care? J Am Med Dir Assoc 15(2), 117–126 (2014)CrossRef König, H.H., Leicht, H., Brettschneider, C., Bachmann, C., Bickel, H., Fuchs, A., Jessen, F., Kohler, M., Luppa, M., Mosch, E., Pentzek, M., Werle, J., Weyerer, S., Wiese, B., Scherer, M., Maier, W., Riedel-Heller, S.G.: The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care? J Am Med Dir Assoc 15(2), 117–126 (2014)CrossRef
14.
Zurück zum Zitat van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur J Health Econ HEPAC Health Econ Prevent Care 5(1), 36–45 (2004)CrossRef van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur J Health Econ HEPAC Health Econ Prevent Care 5(1), 36–45 (2004)CrossRef
15.
Zurück zum Zitat Federal Statistical Office: Predicted change of the number of potential informal care givers and persons in need for care in the years from 2006 to 2050 in Germany (2008) Federal Statistical Office: Predicted change of the number of potential informal care givers and persons in need for care in the years from 2006 to 2050 in Germany (2008)
16.
Zurück zum Zitat Leicht, H., Heinrich, S., Heider, D., Bachmann, C., Bickel, H., van den Bussche, H., Fuchs, A., Luppa, M., Maier, W., Mosch, E., Pentzek, M., Rieder-Heller, S.G., Tebarth, F., Werle, J., Weyerer, S., Wiese, B., Zimmermann, T., Konig, H.H., AgeCoDe Study Group: Net costs of dementia by disease stage. Acta Psychiatr Scand 124(5), 384–395 (2011)CrossRef Leicht, H., Heinrich, S., Heider, D., Bachmann, C., Bickel, H., van den Bussche, H., Fuchs, A., Luppa, M., Maier, W., Mosch, E., Pentzek, M., Rieder-Heller, S.G., Tebarth, F., Werle, J., Weyerer, S., Wiese, B., Zimmermann, T., Konig, H.H., AgeCoDe Study Group: Net costs of dementia by disease stage. Acta Psychiatr Scand 124(5), 384–395 (2011)CrossRef
17.
Zurück zum Zitat Schwarzkopf, L., Menn, P., Leidl, R., Graessel, E., Holle, R.: Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data. BMC Health Serv Res 13, 2 (2013)CrossRef Schwarzkopf, L., Menn, P., Leidl, R., Graessel, E., Holle, R.: Are community-living and institutionalized dementia patients cared for differently? Evidence on service utilization and costs of care from German insurance claims data. BMC Health Serv Res 13, 2 (2013)CrossRef
18.
Zurück zum Zitat Boustani, M., Peterson, B., Hanson, L., Harris, R., Lohr, K.N.: Force, U.S.P.S.T.: Screening for dementia in primary care: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 138(11), 927–937 (2003)CrossRef Boustani, M., Peterson, B., Hanson, L., Harris, R., Lohr, K.N.: Force, U.S.P.S.T.: Screening for dementia in primary care: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 138(11), 927–937 (2003)CrossRef
19.
Zurück zum Zitat Connolly, A., Gaehl, E., Martin, H., Morris, J., Purandare, N.: Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health 15(8), 978–984 (2011)CrossRef Connolly, A., Gaehl, E., Martin, H., Morris, J., Purandare, N.: Underdiagnosis of dementia in primary care: variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health 15(8), 978–984 (2011)CrossRef
20.
Zurück zum Zitat Eichler, T., Thyrian, J.R., Hertel, J., Kohler, L., Wucherer, D., Dreier, A., Michalowsky, B., Teipel, S., Hoffmann, W.: Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial. J Alzheimer’s Dis JAD 42(2), 451–458 (2014)CrossRef Eichler, T., Thyrian, J.R., Hertel, J., Kohler, L., Wucherer, D., Dreier, A., Michalowsky, B., Teipel, S., Hoffmann, W.: Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial. J Alzheimer’s Dis JAD 42(2), 451–458 (2014)CrossRef
21.
Zurück zum Zitat Michalowsky, B., Eichler, T., Thyrian, J.R., Hertel, J., Wucherer, D., Hoffmann, W., Flessa, S.: Healthcare resource utilization and cost in dementia: are there differences between patients screened positive for dementia with and those without a formal diagnosis of dementia in primary care in Germany? Int Psychogeriatr 28(3), 359–369 (2016)CrossRef Michalowsky, B., Eichler, T., Thyrian, J.R., Hertel, J., Wucherer, D., Hoffmann, W., Flessa, S.: Healthcare resource utilization and cost in dementia: are there differences between patients screened positive for dementia with and those without a formal diagnosis of dementia in primary care in Germany? Int Psychogeriatr 28(3), 359–369 (2016)CrossRef
22.
Zurück zum Zitat Reese, J.P., Hessmann, P., Seeberg, G., Henkel, D., Hirzmann, P., Rieke, J., Baum, E., Dannhoff, F., Muller, M.J., Jessen, F., Geldsetzer, M.B., Dodel, R.: Cost and care of patients with Alzheimer’s disease: clinical predictors in German health care settings. J Alzheimer’s Dis JAD 27(4), 723–736 (2011)CrossRef Reese, J.P., Hessmann, P., Seeberg, G., Henkel, D., Hirzmann, P., Rieke, J., Baum, E., Dannhoff, F., Muller, M.J., Jessen, F., Geldsetzer, M.B., Dodel, R.: Cost and care of patients with Alzheimer’s disease: clinical predictors in German health care settings. J Alzheimer’s Dis JAD 27(4), 723–736 (2011)CrossRef
23.
Zurück zum Zitat Thyrian, J.R., Fiss, T., Dreier, A., Bowing, G., Angelow, A., Lueke, S., Teipel, S., Flessa, S., Grabe, H.J., Freyberger, H.J., Hoffmann, W.: Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial. Trials 13, 56 (2012)CrossRef Thyrian, J.R., Fiss, T., Dreier, A., Bowing, G., Angelow, A., Lueke, S., Teipel, S., Flessa, S., Grabe, H.J., Freyberger, H.J., Hoffmann, W.: Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial. Trials 13, 56 (2012)CrossRef
24.
Zurück zum Zitat Thyrian, J.R., Eichler, T., Michalowsky, B., Wucherer, D., Reimann, M., Hertel, J., Richter, S., Dreier, A., Hoffmann, W.: Community-Dwelling People Screened Positive for Dementia in Primary Care: A Comprehensive. Multivariate Descriptive Analysis Using Data from the DelpHi-Study, J Alzheimers Dis (2016) Thyrian, J.R., Eichler, T., Michalowsky, B., Wucherer, D., Reimann, M., Hertel, J., Richter, S., Dreier, A., Hoffmann, W.: Community-Dwelling People Screened Positive for Dementia in Primary Care: A Comprehensive. Multivariate Descriptive Analysis Using Data from the DelpHi-Study, J Alzheimers Dis (2016)
25.
Zurück zum Zitat Kalbe, E., Kessler, J., Calabrese, P., Smith, R., Passmore, A.P., Brand, M., Bullock, R.: DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 19(2), 136–143 (2004)CrossRef Kalbe, E., Kessler, J., Calabrese, P., Smith, R., Passmore, A.P., Brand, M., Bullock, R.: DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia. Int J Geriatr Psychiatry 19(2), 136–143 (2004)CrossRef
26.
Zurück zum Zitat Michalowsky, B., Thyrian, J.R., Eichler, T., Hertel, J., Wucherer, D., Flessa, S., Hoffmann, W.: Economic analysis of formal care, informal care, and productivity losses in primary care patients who screened positive for dementia in Germany. J Alzheimers Dis 50(1), 47–59 (2015)CrossRef Michalowsky, B., Thyrian, J.R., Eichler, T., Hertel, J., Wucherer, D., Flessa, S., Hoffmann, W.: Economic analysis of formal care, informal care, and productivity losses in primary care patients who screened positive for dementia in Germany. J Alzheimers Dis 50(1), 47–59 (2015)CrossRef
27.
Zurück zum Zitat Wimo, A., Nordberg, G.: Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr 44(1), 71–81 (2007)CrossRef Wimo, A., Nordberg, G.: Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr 44(1), 71–81 (2007)CrossRef
28.
Zurück zum Zitat Kessler, J., Markowitsch, H.J., Denzler, P.: Mini-Mental-Status-Test (MMST) [German Version]. Beltz Test GmbH, Göttingen (1990) Kessler, J., Markowitsch, H.J., Denzler, P.: Mini-Mental-Status-Test (MMST) [German Version]. Beltz Test GmbH, Göttingen (1990)
29.
Zurück zum Zitat Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN): S3-Leitlinie “Demenzen”. Internet (2015) Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN): S3-Leitlinie “Demenzen”. Internet (2015)
30.
Zurück zum Zitat Mackin, R.S., Ayalon, L., Feliciano, L., Arean, P.A.: The sensitivity and specificity of cognitive screening instruments to detect cognitive impairment in older adults with severe psychiatric illness. J Geriatr Psychiatry Neurol 23(2), 94–99 (2010)CrossRef Mackin, R.S., Ayalon, L., Feliciano, L., Arean, P.A.: The sensitivity and specificity of cognitive screening instruments to detect cognitive impairment in older adults with severe psychiatric illness. J Geriatr Psychiatry Neurol 23(2), 94–99 (2010)CrossRef
31.
Zurück zum Zitat Kohn, N., Kalbe, E., Georg, H., Kessler, J.: Vergleich MMST und DemTect: Spezifität und Sensitivität bei primär kognitiven Störungen. Akt Neurol 34 (2007) Kohn, N., Kalbe, E., Georg, H., Kessler, J.: Vergleich MMST und DemTect: Spezifität und Sensitivität bei primär kognitiven Störungen. Akt Neurol 34 (2007)
32.
Zurück zum Zitat Hindmarch, I., Lehfeld, H., de Jongh, P., Erzigkeit, H.: The Bayer Activities of Daily Living Scale (B-ADL). Dement Geriatr Cogn Disord 9(Suppl 2), 20–26 (1998)CrossRef Hindmarch, I., Lehfeld, H., de Jongh, P., Erzigkeit, H.: The Bayer Activities of Daily Living Scale (B-ADL). Dement Geriatr Cogn Disord 9(Suppl 2), 20–26 (1998)CrossRef
33.
Zurück zum Zitat Erzigkeit, H., Lehfeld, H., Pena-Casanova, J., Bieber, F., Yekrangi-Hartmann, C., Rupp, M., Rappard, F., Arnold, K., Hindmarch, I.: The Bayer-Activities of Daily Living Scale (B-ADL): results from a validation study in three European countries. Dement Geriatr Cogn Disord 12(5), 348–358 (2001)CrossRef Erzigkeit, H., Lehfeld, H., Pena-Casanova, J., Bieber, F., Yekrangi-Hartmann, C., Rupp, M., Rappard, F., Arnold, K., Hindmarch, I.: The Bayer-Activities of Daily Living Scale (B-ADL): results from a validation study in three European countries. Dement Geriatr Cogn Disord 12(5), 348–358 (2001)CrossRef
34.
Zurück zum Zitat Gauggel, S., Birkner, B.: Validity and reliability of a German version of the Geriatric Depression Scale (GDS). Zeitschrift für Klinische Psychologie-Forschung und Praxis 28(1), 18–27 (1999)CrossRef Gauggel, S., Birkner, B.: Validity and reliability of a German version of the Geriatric Depression Scale (GDS). Zeitschrift für Klinische Psychologie-Forschung und Praxis 28(1), 18–27 (1999)CrossRef
35.
Zurück zum Zitat Byford, S., Torgerson, D.J., Raftery, J.: Economic note: cost of illness studies. BMJ 320(7245), 1335 (2000)CrossRef Byford, S., Torgerson, D.J., Raftery, J.: Economic note: cost of illness studies. BMJ 320(7245), 1335 (2000)CrossRef
36.
Zurück zum Zitat Federal Statistical Office: Verdienste und Arbeitskosten-Arbeitnehmerverdienste. Federal Statistical Office (2015) Federal Statistical Office: Verdienste und Arbeitskosten-Arbeitnehmerverdienste. Federal Statistical Office (2015)
37.
Zurück zum Zitat Statistische Ämter des Bundes und der Länder: Preise- Verbraucherpreisindizies für Deutschland. Jahresbericht 2013. In: (2014) Statistische Ämter des Bundes und der Länder: Preise- Verbraucherpreisindizies für Deutschland. Jahresbericht 2013. In: (2014)
38.
Zurück zum Zitat Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany–a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67(10), 736–746 (2005)CrossRef Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany–a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67(10), 736–746 (2005)CrossRef
39.
Zurück zum Zitat Bock, J.O., Brettschneider, C., Seidl, H., Bowles, D., Holle, R., Greiner, W., Konig, H.H.: Calculation of standardised unit costs from a societal perspective for health economic evaluation. Gesundheitswesen 77(1), 53–61 (2015)PubMed Bock, J.O., Brettschneider, C., Seidl, H., Bowles, D., Holle, R., Greiner, W., Konig, H.H.: Calculation of standardised unit costs from a societal perspective for health economic evaluation. Gesundheitswesen 77(1), 53–61 (2015)PubMed
41.
Zurück zum Zitat Statistische Ämter des Bundes und der Länder: Kostennachweis der Krankenhäuser 2012. In: Fachserie 12 Reihe 6.3. (2013) Statistische Ämter des Bundes und der Länder: Kostennachweis der Krankenhäuser 2012. In: Fachserie 12 Reihe 6.3. (2013)
43.
Zurück zum Zitat WIdO (Wissenschaftliches Institut der AOK): Heilmittel- Einzelpreise in EURO nach Kassenart-Stand Mai 2014. In. (2014) WIdO (Wissenschaftliches Institut der AOK): Heilmittel- Einzelpreise in EURO nach Kassenart-Stand Mai 2014. In. (2014)
44.
Zurück zum Zitat Statistische Ämter des Bundes und der Länder: Pflegestatistik 2013-Pflege im Rahmen der Pflegeversicherung. Deutschlandergebnisse In, Wiesbaden (2015) Statistische Ämter des Bundes und der Länder: Pflegestatistik 2013-Pflege im Rahmen der Pflegeversicherung. Deutschlandergebnisse In, Wiesbaden (2015)
46.
Zurück zum Zitat Desgagne, A., Castilloux, A.M., Angers, J.F., LeLorier, J.: The use of the bootstrap statistical method for the pharmacoeconomic cost analysis of skewed data. Pharmacoeconomics 13(5 Pt 1), 487–497 (1998)CrossRef Desgagne, A., Castilloux, A.M., Angers, J.F., LeLorier, J.: The use of the bootstrap statistical method for the pharmacoeconomic cost analysis of skewed data. Pharmacoeconomics 13(5 Pt 1), 487–497 (1998)CrossRef
47.
Zurück zum Zitat StataCorp: Stata Statistical Software: Release 13. In. College Station, TX: StataCorp LP, (2014) StataCorp: Stata Statistical Software: Release 13. In. College Station, TX: StataCorp LP, (2014)
48.
Zurück zum Zitat Zhu, C.W., Cosentino, S., Ornstein, K., Gu, Y., Scarmeas, N., Andrews, H., Stern, Y.: Medicare utilization and expenditures around incident dementia in a multiethnic cohort. J Gerontol Series A Biol Sci Med Sci 70(11), 1448–1453 (2015)CrossRef Zhu, C.W., Cosentino, S., Ornstein, K., Gu, Y., Scarmeas, N., Andrews, H., Stern, Y.: Medicare utilization and expenditures around incident dementia in a multiethnic cohort. J Gerontol Series A Biol Sci Med Sci 70(11), 1448–1453 (2015)CrossRef
49.
Zurück zum Zitat Schulnburg, J., Schulenburg, I., Horn, R.: Cost of treatment and care of Alzheimer´s disease in Germany. In: Wimo, A.S.S.S., Jönsson, B., Karlsson, G., Winblad, B. (eds.) Health economics of dementia. Wiley, Chichester (1998) Schulnburg, J., Schulenburg, I., Horn, R.: Cost of treatment and care of Alzheimer´s disease in Germany. In: Wimo, A.S.S.S., Jönsson, B., Karlsson, G., Winblad, B. (eds.) Health economics of dementia. Wiley, Chichester (1998)
50.
Zurück zum Zitat Ducharme, F., Levesque, L., Lachance, L., Kergoat, M.J., Coulombe, R.: Challenges associated with transition to caregiver role following diagnostic disclosure of Alzheimer disease: a descriptive study. Int J Nurs Stud 48(9), 1109–1119 (2011)CrossRef Ducharme, F., Levesque, L., Lachance, L., Kergoat, M.J., Coulombe, R.: Challenges associated with transition to caregiver role following diagnostic disclosure of Alzheimer disease: a descriptive study. Int J Nurs Stud 48(9), 1109–1119 (2011)CrossRef
51.
Zurück zum Zitat Leicht, H., Konig, H.H., Stuhldreher, N., Bachmann, C., Bickel, H., Fuchs, A., Heser, K., Jessen, F., Kohler, M., Luppa, M., Mosch, E., Pentzek, M., Riedel-Heller, S., Scherer, M., Werle, J., Weyerer, S., Wiese, B., Maier, W., AgeCoDe Study Group: Predictors of costs in dementia in a longitudinal perspective. PLoS One 8(7), e70018 (2013)CrossRef Leicht, H., Konig, H.H., Stuhldreher, N., Bachmann, C., Bickel, H., Fuchs, A., Heser, K., Jessen, F., Kohler, M., Luppa, M., Mosch, E., Pentzek, M., Riedel-Heller, S., Scherer, M., Werle, J., Weyerer, S., Wiese, B., Maier, W., AgeCoDe Study Group: Predictors of costs in dementia in a longitudinal perspective. PLoS One 8(7), e70018 (2013)CrossRef
52.
Zurück zum Zitat Joling, K.J., Schope, J., van Hout, H.P., van Marwijk, H.W., van der Horst, H.E., Bosmans, J.E.: Predictors of Societal Costs in Dementia Patients and Their Informal Caregivers: A Two-Year Prospective Cohort Study. Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry 23(11), 1193–1203 (2015)CrossRef Joling, K.J., Schope, J., van Hout, H.P., van Marwijk, H.W., van der Horst, H.E., Bosmans, J.E.: Predictors of Societal Costs in Dementia Patients and Their Informal Caregivers: A Two-Year Prospective Cohort Study. Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry 23(11), 1193–1203 (2015)CrossRef
53.
Zurück zum Zitat Bergmann, K., Foster, E.M., Justice, A.W., Matthews, V.: Management of the demented elderly patient in the community. Br J Psychiatry 132, 441–449 (1978)CrossRef Bergmann, K., Foster, E.M., Justice, A.W., Matthews, V.: Management of the demented elderly patient in the community. Br J Psychiatry 132, 441–449 (1978)CrossRef
54.
Zurück zum Zitat Statistische Ämter des Bundes und der Länder: Demografischer Wandel in Deutschland-Auswirkungen auf Krankenhausbehandlungen und Pflegebedürftige im Bund und in den Ländern. In: Länder, S.Ä.d.B.u.d. (ed.) Demografischer Wandel in Deutschland. pp. 2–34. Wiesbaden (2008) Statistische Ämter des Bundes und der Länder: Demografischer Wandel in Deutschland-Auswirkungen auf Krankenhausbehandlungen und Pflegebedürftige im Bund und in den Ländern. In: Länder, S.Ä.d.B.u.d. (ed.) Demografischer Wandel in Deutschland. pp. 2–34. Wiesbaden (2008)
55.
Zurück zum Zitat Tarricone, R.: Cost-of-illness analysis. What room in health economics? Health Policy 77(1), 51–63 (2006)CrossRef Tarricone, R.: Cost-of-illness analysis. What room in health economics? Health Policy 77(1), 51–63 (2006)CrossRef
Metadaten
Titel
Healthcare utilization and costs in primary care patients with dementia: baseline results of the DelpHi-trial
verfasst von
Bernhard Michalowsky
Steffen Flessa
Tilly Eichler
Johannes Hertel
Adina Dreier
Ina Zwingmann
Diana Wucherer
Henriette Rau
Jochen René Thyrian
Wolfgang Hoffmann
Publikationsdatum
03.02.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
The European Journal of Health Economics / Ausgabe 1/2018
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-017-0869-7

Weitere Artikel der Ausgabe 1/2018

The European Journal of Health Economics 1/2018 Zur Ausgabe