Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-28T07:18:53.254Z Has data issue: false hasContentIssue false

Cost-Utility Analysis of Group Living in Dementia Care

Published online by Cambridge University Press:  10 March 2009

Anders Wimo
Affiliation:
Umeå University and the Primary Health Care Research Unit of Medelpad
Bengt Mattson
Affiliation:
Umeå University
Ingvar Krakau
Affiliation:
Karolinska Hospital
Tua Eriksson
Affiliation:
The Primary Health Care Research Unit of Medelpad
Anders Nelvig
Affiliation:
The Geriatric Clinic, Sundsvall
Goran Karlsson
Affiliation:
Linköping University

Abstract

A cost-utility analysis (CUA) was applied to group living for dementia patients. A Markov-model of an expected life-length of 8 years was used. Forty-six patients in group living were compared to 39 patients living at home by inclusion and 23 institutionalized patients. When the cost per gained quality-adjusted life-year (QALY) was calculated, the group living alternative was the most favorable for the patients, giving a cost per paired QALY of US dollars > 0. In the extensive sensitivity analysis the main result was consistent but methodological problems were indicated.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Asplund, K., Adolfsson, R., Lundgren, K., et al. Gruppboende för aldersdementa-erfarenheter efter 2 ar. Lakartidningen, 1988, 85, 734–37.Google Scholar
2.Asplund, K., Wimo, A.Aggressivitet och motoriska problem tvingar dementa lämna gruppboende. Läkartidningen, 1990; 87, 1555–6.Google Scholar
3.Bloom, B. S., Soper, K. A.Health and medical care for the elderly and aged population: The state of evidence. Journal of the American Geriatrics Society, 1980, 28, 451–55.CrossRefGoogle Scholar
4.Beck, J. R., Pauker, S. G.The Markov process in medical prognosis. Medical decision making, 1983, 4, 419–58.CrossRefGoogle Scholar
5.Brorsson, B., Wall, S.Värdering av medicinsk teknologi. Stockholm: Medicinska Forskningsradet. 1984.Google Scholar
6.Campbell, D. T., Stanley, J. C.Experimental and quasi-experimental designs for research. Chicago: Rand McNally, 1966.Google Scholar
7.Department of Clinical Epidemiology and Biostatistics, McMaster University Health Sciences Centre. How to read clinical journals, VII: To understand an economic evaluation. Canadian Medical Association Journal, 1984, 130, 1428–32.Google Scholar
8.Drummond, M., Stoddart, G. L., Torrance, G. E. W.Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1987.Google Scholar
9.Folstein, M. F., Folstein, S. E., McHugh, P. R.“Mini-mental” state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 1975, 12, 189–98.CrossRefGoogle Scholar
10.Friedman, L. M., Furberg, C. D., DeMets, D. L.Fundamentals of clinical trials, 2nd ed.Littleton, MA: PSG Publishing Company, Inc, 1985.Google Scholar
11.Gudex, C.QALYS and their use by the health service, discussion paper 20. York, UK: Centre for Health Economics, University of York, 10 1986.Google Scholar
12.Gustafsson, L.Quest, ett programsystem för statistisk och epidemiologisk dataanalys. 1987. Umeå, Sweden: Statistiska institutionen, Umeå Universitet, 1987.Google Scholar
13.Johansson, L.Caring for the next of kin. Unpublished dissertation. Uppsala, Sweden: University of Uppsala, 1991.Google Scholar
14.Kaplan, R. M., Busch, J. W., Berry, C. C.Health status: Types of validity and the index of well-being. Health Services Research, 1976, 11:478507.Google ScholarPubMed
15.Kaplan, R. M., Bush, J. W., Berry, C. C.Health status index: Category rating versus magnitude estimation for measuring levels of well-being. Medical Care, 1979, 17:501–25.CrossRefGoogle ScholarPubMed
16.Kwoh, C. K.Cost studies: Caveats to the reader (editorial). Journal of Clinical Epidemiology, 1988, 41:211–13.CrossRefGoogle Scholar
17.Reisberg, B., Ferris, S., de Leon, M. J., Crook., T.The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 1982, 139, 1136–39.Google ScholarPubMed
18.Reisberg, B., Ferris, S. H., Kluger, A., et al. Symptomatic changes in CNS aging and dementia of the Alzheimer type: Cross-sectional, temporal and remediable concomitants. In Bergener, M., Reisberg, B., (eds). Diagnosis and treatment of senile dementia. Berlin-Heidelberg: Springer Verlag, 1989, 193223.CrossRefGoogle Scholar
19.Rosser, R., Kind, P.A scale of valuations of states of illness: Is there a social consensus? International Journal of Epidemiology, 1978, 347–58.CrossRefGoogle Scholar
20.Sandman, P. O., Adolfsson, R., Norberg, A., Nyström, L., Winblad, B.The long-time care of the elderly: A descriptive study of 3600 patients living in different institutions in the county of Vasterbotten, Sweden. Comprehensive Gerontology, 1988, 2, 120–32.Google Scholar
21.SPRI (Sjuvårdens planerings och rationaliseringsinstitut). Äldeomsorg och ekonomi. SPRI-rapport 164, 2nd ed.Stockholm: SPRI, 1985.Google Scholar
22.Statistiska Centralbyrån (Official Statistics of Sweden). Statistical Yearbook of Sweden, 1992. Stockholm, Statistiska Centralbyrån, 1992.Google Scholar
23.Torrance, G. W.Measurement of health state utilities for economical appraisal. Journal of Health Economics, 1986, 5, 130.CrossRefGoogle ScholarPubMed
24.Torrance, G. W.Utility approach to measuring health-related quality of life. Journal of Chronic Diseases, 1987, 40, 593600.CrossRefGoogle ScholarPubMed
25.Weinstein, M. C.Principles of cost-effective resource allocation in health care organizations. International Journal of Technology Assessment in Health Care, 1990, 6, 83103.CrossRefGoogle ScholarPubMed
26.Wimo, A., Ineichen, B., Mattsson, B., Kallioinen, M.Assessments of productivity of psycho-geriatric day care. International Journal of Geriatric Psychiatry, 1993, 8, 675–79.CrossRefGoogle Scholar
27.Wimo, A., Wallin, J. O., Lundgren, K. et al. Group living, an alternative for dementia patients: A cost analysis. International Journal of Geriatric Psychiatry, 1991, 6, 2129.CrossRefGoogle Scholar
28.Wimo, A., Wallin, J. O., Lundgren, K., et al. Dagvard och gruppboende for aldersdementa-en kostnadsanalys. Lakartidningen, 1988, 85, 729–33.Google Scholar