Excess costs of dementia disorders and the role of age and gender - an analysis of German health and long-term care insurance claims dataReport as inadecuate




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BMC Health Services Research

, 12:165

First Online: 19 June 2012Received: 08 February 2012Accepted: 30 May 2012DOI: 10.1186-1472-6963-12-165

Cite this article as: Schwarzkopf, L., Menn, P., Leidl, R. et al. BMC Health Serv Res 2012 12: 165. doi:10.1186-1472-6963-12-165

Abstract

BackgroundDemographic ageing is associated with an increasing number of dementia patients, who reportedly incur higher costs of care than individuals without dementia. Regarding Germany, evidence on these excess costs is scarce. Adopting a payer perspective, our study aimed to quantify the additional yearly expenditures per dementia patient for various health and long-term care services. Additionally, we sought to identify gender-specific cost patterns and to describe age-dependent cost profiles.

MethodsThe analyses used 2006 claims data from the AOK Bavaria Statutory Health Insurance fund of 9,147 dementia patients and 29,741 age- and gender-matched control subjects. Cost predictions based on two-part regression models adjusted for age and gender and excess costs of dementia care refer to the difference in model-estimated means between both groups. Corresponding analyses were performed stratified for gender. Finally, a potentially non-linear association between age and costs was investigated within a generalized additive model.

ResultsYearly spending within the social security system was circa €12,300 per dementia patient and circa €4,000 per non-demented control subject. About two-thirds of the additional expenditure for dementia patients occurred in the long-term care sector. Within our study sample, male and female dementia patients incurred comparable total costs. However, women accounted for significantly lower health and significantly higher long-term care expenditures. Long-term care spending increased in older age, whereupon health care spending decreased. Thus, at more advanced ages, women incurred greater costs than men of the same age.

ConclusionsDementia poses a substantial additional burden to the German social security system, with the long-term care sector being more seriously challenged than the health care sector. Our results suggest that female dementia patients need to be seen as a key target group for health services research in an ageing society. It seems clear that strategies enabling community-based care for this vulnerable population might contribute to lowering the financial burden caused by dementia. This would allow for the sustaining of comprehensive dementia care within the social security system.

KeywordsPayer perspective Administrative data Net expenditures Economics Health care sector Long-term care sector Nursing care Case–control study Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-12-165 contains supplementary material, which is available to authorized users.

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Author: Larissa Schwarzkopf - Petra Menn - Reiner Leidl - Sonja Wunder - Hilmar Mehlig - Peter Marx - Elmar Graessel - Rolf Holle

Source: https://link.springer.com/







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