Cost-effectiveness-analysis of the Dementia-Care-Management by using the health survey SF-12 – Results of general practitioner based, cluster randomized, interventional trial DelpHi-MV

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Background: The current number of persons with dementia (PwDs) is estimated to amount to 1.5 million in Germany. In light of the predicted increase in life expectancy and the rise of the number of persons in higher age groups, the number of dementia cases is estimated to double by 2050. Furthermore, dementia is associated with substantial healthcare costs. Thus, aging society coupled with increasing prevalence and with expanding costs is a serious healthcare priority. Since causal treatment of dementia is still out of sight, there is a considerable need for more effective ways of dementia care, like care and case management programs. Economic evaluations of dementia care management programs have produced inconclusive evidence and lacked on long-term studies. Evaluations conducted in Germany are still missing.Objectives: The objective is to learn the methods to perform a best-practice cost-utility-analysis of the DelpHi-Intervention. This should be done in close cooperation with Feng Xie, Associate Professor of Health Economics in the Department of Clinical Epidemiology and Biostatistics, McMaster University (Canada). Based on the learned best-practice method, the aim is to evaluate the incremental cost effectiveness ratio (ICER) of the DelpHi-Intervention. Therefore, (1) the health-related quality of life (HRQoL) measured by using the health survey Short Form 12 (SF-12) should be converted into preference-based values and (2) quality-adjusted life years (QALYs) have to be calculated. To evaluate the ICER, (3) QALYs and total cost, including both intervention cost and healthcare cost, finally have to be compared between intervention and controls of the DelpHi-trial.Study design: The present analysis is based on the study DelpHi-MV (Dementia: life- and person-centred help in Mecklenburg-Western Pomerania), a general practitioner (GP) based, cluster-randomized controlled intervention trial in a primary care setting. The intervention aims to provide optimum care by integrating multi-professional and multimodal strategies to individualize and optimize treatment of dementia, conducted by Dementia Care Managers, nurses with dementia-specific training. The DCM develops and implements an intervention plan tailored to the individual conditions of the PwD in close cooperation with the GP.Sample: Eligible patients (70 years and older, living at home) were screened in GP practices for dementia. 6,838 people were screened by 125 GPs. 1,166 patients of 105 GPs were eligible for the study. 634 participants agreed to participate, and 516 participants at 94 GPs started the baseline assessment. Follow-up 1 was completed with 408 participants in March 2016. Follow-up 2 was completed with 350 participants in March 2017. Data basis for the calculation of the ICER should be the baseline assessment, the follow up1 and the follow up 2 of the DelpHi-MV study.Expected results: The DelpHi-Intervention could be the first cost-effective dementia care management worldwide.