Predictors of costs of care in Alzheimer's disease: A multinational sample of 1222 patients
Predictors of costs of care in Alzheimer's disease: A multinational sample of 1222 patients
复制标题
DOI：
10.1016/j.jalz.2010.09.001
复制
发表时间：
2011-05-01
影响因子：
14
通讯作者：
Jonsson, Linus
中科院分区：
文献类型：
--
作者：
Gustavsson, Anders;Brinck, Per;Jonsson, Linus
背景：阿尔茨海默病患者的护理费用与疾病严重程度的关键指标相关。这种关系在新疗法的经济评估中非常重要，并用于通过经济建模将治疗功效转化为对成本的影响。我们的目的是确定什么措施的疾病严重程度是最重要的预测社会成本的护理和他们的关系是否不同countries.Methods：访谈进行了1222病人和照顾者对居住在社区或在住宅护理设置在西班牙，瑞典，英国和美国。评估包括护理费用（痴呆症的资源利用）和关键疾病严重程度指标：认知功能（简易精神状态检查），日常生活活动能力（ADL能力，痴呆症残疾评估[DAD]）和行为症状（神经精神病学调查表（NPI）-严重程度）。在所有国家，ADL能力是社区居住患者护理社会成本的最重要预测因素。DAD下降一个百分点导致西班牙、英国和美国的护理成本平均增加1.4%，瑞典增加2%。这转化为平均DAD标准差下降45%的增加。NPI严重程度和简易精神状态检查也是重要的预测因子，但影响较小。虽然平均成本的护理不同的国家，重要的预测因素是相同的。结论：ADL能力是最重要的预测社会成本的护理在社区住宅，无论国家，因此应该是中央阿尔茨海默氏症治疗的经济评估。(C)2011年，阿尔茨海默氏症协会。All rights reserved.
Background: The costs of care for patients with Alzheimer's disease are correlated with key measures of disease severity. This relationship is important in the economic evaluation of new treatments and is used to translate treatment efficacy into effects on costs through economic modeling. We aimed to identify what measures of disease severity are the most important predictors of societal costs of care and whether their relationship differs across countries.Methods: Interviews were conducted with 1222 patient and caregiver pairs residing in the community or in residential care settings in Spain, Sweden, United Kingdom, and the United States. Assessments included costs of care (Resource Utilization in Dementia) and key disease severity measures: cognitive function (Mini-Mental State Examination), ability to perform Activities of Daily Living (ADL-ability, Disability Assessment for Dementia [DAD]), and behavioral symptoms (Neuropsychiatry Inventory (NPI)-severity).Results: ADL-ability was the most important predictor of societal costs of care of community-dwelling patients in all countries. A one-point decrease in DAD resulted in a 1.4% increase in costs of care in Spain, United Kingdom, and the United States on average, and a 2% increase in Sweden. This translated into a 45% increase from a standard deviation decrease in DAD on average. NPI-severity and Mini-Mental State Examination were also significant predictors but with lesser effect. Although mean costs of care differed across countries, the important predictors were the same.Conclusion: ADL-ability is the most important predictor of societal costs of care in community dwellings irrespective of country and should therefore be central in the economic evaluation of Alzheimer's disease therapies. (C) 2011 The Alzheimer's Association. All rights reserved.