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Cost of informal care for community-dwelling mild–moderate dementia patients in a developed Southeast Asian country

Published online by Cambridge University Press:  22 May 2013

Mei Sian Chong ,
Woan Shin Tan ,
Mark Chan ,
Wee Shiong Lim ,
Noorhazlina Ali ,
Yue Ying Ang  and
Kia Chong Chua
Mei Sian Chong*
Affiliation:
Cognition and Memory Disorders Service, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
Woan Shin Tan
Affiliation:
Health Services & Outcomes Research Department, National Healthcare Group, Singapore
Mark Chan
Affiliation:
Cognition and Memory Disorders Service, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
Wee Shiong Lim
Affiliation:
Cognition and Memory Disorders Service, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
Noorhazlina Ali
Affiliation:
Cognition and Memory Disorders Service, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
Yue Ying Ang
Affiliation:
Cognition and Memory Disorders Service, Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
Kia Chong Chua
Affiliation:
Institute of Psychiatry, King's College London, London, UK
*
Correspondence should be addressed to: Dr Mei Sian Chong, Senior Consultant, 11 Jalan, Tan Tock Seng S308433, Singapore. Phone: +65-6357-7859; Fax: +65-6357-7837. Email: [email protected].
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Abstract

Background: Cost of informal care constitutes an important component of total dementia care cost. It also reflects resource utilization by patients and caregivers. We aim to quantify the informal cost of care for mild to moderate dementia patients.

Methods: We recruited 165 patient–caregiver dyads with mild to moderate dementia. Informal care burden was assessed using the Resource Utilization in Dementia (RUD)-Lite instrument. A generalized linear model was fitted for association between cost of informal care and cognitive impairment, taking into account patient demographics, disease factors, and use of paid domestic help. Marginal estimates were obtained from the model for the purpose of illustration and discussion.

Results: Total hours of informal care by primary caregiver doubled in moderate dementia patients, with 57.9% having paid domestic help to assist in care. Functional factors and use of paid domestic help were significantly associated with informal care costs. Costs were consistently higher for patients without paid domestic help for mild- and moderate dementia.

Conclusion: This study demonstrates the informal care costs of caring for mild–moderate dementia patients in Singapore, with the unique cost savings provided by live-in paid domestic help, and potentially may aid policy-makers in allocation of resources and support to caregivers.

Keywords

dementiabehaviorhealth economy
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1475 - 1483
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Bartus, T. (2005). Estimation of marginal effects using margeff. The Stata Journal, 5, 309–329.CrossRefGoogle Scholar
Bergvall, N.et al. (2011). Relative importance of patient disease indicators on informal care and caregiver burden in Alzheimer's disease. International Psychogeriatrics, 2, 73–85.CrossRefGoogle Scholar
Bucks, R. S, Ashworth, D. L., Wilcock, G. K. and Siegfried, K. (1996). Assessment of activities of daily living in dementia: development of the Bristol Activities of Daily Living Scale. Age and Ageing, 25, 113–120.CrossRefGoogle ScholarPubMed
Cameron, A. and Trivedi, P. (2010). Nonlinear regression methods. In Microeconometrics Using Stata (2nd edn., pp. 320–362). College Station, TX: Stata Press.Google Scholar
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.CrossRefGoogle ScholarPubMed
Drummond, M. F., O'Brien, B., Stoddart, G. L. and Torrance, G. W. (1997). Methods for the Economic Evaluation of Health Care Programmes. New York: Oxford University Press.Google Scholar
Gustavsson, A.et al. (2010). Differences in resource use and costs of dementia care between European countries: baseline data from the ICTUS Study. Journal of Nutrition Health and Aging, 14, 648–654.CrossRefGoogle ScholarPubMed
Gustavsson, A., Cattelin, F. and Jonsson, L. (2011). Costs of care in a mild-to-moderate Alzheimer clinical trial sample: key resources and their determinants. Alzheimer's & Dementia, 7, 466–473.CrossRefGoogle Scholar
Lafortune, L., Beland, F., Bergman, H. and Ankri, J. (2009). Health state profiles and service utilization in community-living elderly. Medical Care, 47, 286–294.CrossRefGoogle ScholarPubMed
Leicht, H.et al. (2011). Net costs of dementia by disease stage. Acta Psychiatrica Scandinavica, 124, 384–395.CrossRefGoogle ScholarPubMed
Lim, W. S., Chin, J. J., Lam, C. K., Lim, P. P. J. and Sahadevan, S. (2005). Clinical dementia rating experience of a multi-racial Asian population. Alzheimer Disease & Associated Disorders, 19, 135–142.CrossRefGoogle ScholarPubMed
Manning, W. G. and Mullahy, J. (2001). Estimating log models: to transform or not to transform? Journal of Health Economics, 20, 461–494.CrossRefGoogle ScholarPubMed
Mauskopf, J., Racketa, J. and Sherrill, E. (2010). Alzheimer's disease: the strength of association of costs with different measures of disease severity. Journal of Nutrition Health and Aging, 14, 655–663.CrossRefGoogle ScholarPubMed
Moore, M. H., Zhu, C. W. and Clipp, E. C. (2001). Informal costs of dementia care: estimates form the National Longitudinal Caregiver Study. Journal of Gerontology: Social Sciences, 56 (B), S219–S228.CrossRefGoogle Scholar
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Park, R. E. (1966). Estimation with heteroscedastic error terms. Econometrica, 34, 888.CrossRefGoogle Scholar
Quentin, W., Riedel-Heller, S. G., Luppa, M., Rudolph, A. and Konig, H. H. (2010). Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatrica Scandinavica, 121, 243–259.CrossRefGoogle ScholarPubMed
Sahadevan, S., Tan, N. J., Tan, T. and Tan, S. (1997). Cognitive testing of elderly Chinese people in Singapore: influence of education and age on normative scores. Age and Ageing, 26, 481–486.CrossRefGoogle ScholarPubMed
Schwarzkopf, L.et al. (2011). Costs of care for dementia patients in community setting: an analysis for mild and moderate disease stage. Value in Health, 14, 827–835.CrossRefGoogle ScholarPubMed
Small, G. A., McDonnell, D. D., Brooks, R. L. and Papadopoulos, G. (2002). The impact of symptom severity on the cost of Alzheimer's disease. Journal of the American Geriatrics Society, 50, 321–327.CrossRefGoogle ScholarPubMed
Williams, R. (2012). Using the margins command to estimate and interpret adjusted predictions and marginal effects. Stata Journal, 12, 308–331.CrossRefGoogle Scholar
Wimo, A., Winbald, B., Aguero-Torres, H. and von Strauss, E. (2003). The magnitude of dementia occurrence in the world. Alzheimer Disease & Associated Disorders, 17, 63–67.CrossRefGoogle ScholarPubMed
Wimo, A., Jonsson, L. and Zbrozek, A. (2010). The Resource Utilisation in Dementia (RUD) Instrument is valid for assessing informal care time in community-living patients with dementia. Journal of Nutrition Health and Aging, 14, 685–689.CrossRefGoogle ScholarPubMed
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly, correlates of feelings of burden. The Gerontologist, 20, 649–55.CrossRefGoogle ScholarPubMed