Introduction: Dementias present a global health challenge and give rise to significant economic costs. This study aims to evaluate the economic impact of one-year outpatient healthcare, nursing home, and formal and informal home help costs for all patients referred to the Centre for Cognitive Impairments at the Department of Neurology, Ljubljana University Medical Centre, Slovenia.
Methods: Data was acquired retrospectively from physicians' records and the costs for 2015 were calculated. Total costs were estimated by means of a bottom-up calculation of outpatient visits, diagnostic examinations and anti-dementia medication. In a subgroup of 120 patients with dementia, the Resource Utilization in Dementia questionnaire was used to estimate formal and informal care costs.
Results: A total of 720 patients visited the memory clinic in 2015. Diagnosis at first visit was subjective cognitive or mild cognitive impairment (SCI/ MCI) for 322 patients, dementia for 258 patients, and psychiatric or other disorders for 140 patients. The average annual cost per patient was EUR 578. It was highest for patients with dementia (EUR 751), EUR 550 for patients with SCI/MCI, and lowest for patients with psychiatric and other disorders (EUR 324). Monthly informal and social care costs were between EUR 1,037 and EUR 3,369, depending on the methodology used.
Conclusion: The cost of diagnosing a cognitive disorder depends on how extensive the diagnosis is. With an estimated prevalence of 34,137 persons with dementia in Slovenia, basic diagnostic investigations incur costs of approximately EUR 7 million. Direct medical costs represent a smaller portion of total dementia costs; this is because annual costs for formal and informal home help are estimated at EUR 265 million and nursing home placements at EUR 105 million.
Uvod: Demence so globalni zdravstveni izziv in strošek. Ovrednotili smo ekonomski vpliv enoletnih stroškov ambulantne obravnave, domske oskrbe ter formalne in neformalne pomoči na domu bolnikom, napotenih v Center za kognitivne motnje Nevrološke klinike Univerzitetnega kliničnega centra Ljubljana.
Metode: Podatki so bili pridobljeni za nazaj iz zdravniških izvidov bolnišničnega registra bolnikov. Skupne enoletne stroške v 2015 smo ocenili z izračunom stroškov ambulantnih obiskov, diagnostičnih pregledov in zdravil za demenco. V podskupini 120 bolnikov z demenco smo uporabili Vprašalnik za oceno virov pri demenci za oceno formalnih in neformalnih stroškov.
Rezultati: V letu 2015 je Center za kognitivne motnje obiskalo 720 bolnikov. Diagnoza ob prvem obisku je bila subjektivna ali blaga kognitivna motnja pri 322 bolnikih, demenca pri 258 bolnikih in psihiatrične ali druge motnje pri 140 bolnikih. Povprečni letni stroški so znašali 578 EUR na bolnika, najvišji so bili pri bolnikih z demenco (751 EUR), pri bolnikih s subjektivno ali blago kognitivno motnjo so bili 550 EUR, najnižji pa so bili pri bolnikih s psihiatričnimi in drugimi motnjami (324 EUR). Mesečni neformalni stroški in stroški socialne oskrbe so bili med 1,073 EUR in 3,369 EUR, odvisno od uporabljene metodologije izračuna.
Zaključek: Stroški diagnosticiranja kognitivnih motenj so odvisni od obsežnosti diagnostičnega procesa. Ob ocenjeni prevalenci 34.137 oseb z demenco v Sloveniji bi za izvedbo osnovnih diagnostičnih preiskav odšteli približno 7 milijonov EUR. Neposredni zdravstveni stroški predstavljajo manjši del skupnih stroškov demence, saj ocena neformalnih in drugih formalnih stroškov znaša 265 milijonov EUR in 105 milijonov EUR za nastanitev v domsko varstvo.
Keywords: cognitive impairments; costs of illness; dementia.
© 2022 National Institute of Public Health, Slovenia, published by Sciendo.