Completed projects

IDA-Follow up Project: net costs of dementia
Head/
Team:
Prof. R. Holle
L. Schwarzkopf, Dr.  P. Menn, H. Hänsch
Funding:AOK Bavaria (sickness fund), Federal Association of the AOK, Eisai GmbH, Pfizer Deutschland GmbH
Duration:2 years
ISRCTN Register No.ISRCTN68329593
Description:Based on the experiences of the IDA-project, net costs per dementia patient shall be assessed via insurance claims data. The study population contains people insured with AOK Bavaria with a diagnosis of dementia in 2005 or 2006 who are 65 years or older and reside in the region of Middle-Franconia. Utilization data of all services provided by Statutory Health Insurance and Compulsory Long-Term Care Insurance as well as the corresponding costs will be assessed and compared with an age and gender adjusted control group without dementia disorders.
Objective:Former dementia related cost of illness studies focused on total health care expenditures per dementia patient rather than on differences due to the diagnosis of dementia. The project aims to determine the additional expenditures for a dementia patient from the perspective of the social security system in contrast to a comparable population without dementia diagnosis.

Within this excess cost study a special focus will be put on gender- and age-related differences between cases and controls. Additionally the case group will be divided in further subgroups. For example, we intend to compare community-living and institutionalized dementia patients.

Beyond the pure cost analysis, our study aims also at describing the delivery of services among people with dementia disorders. Therefore we evaluate sequences of care settings as well as characteristic comorbid conditions and their therapy.
Method:Within a claims data analysis we will compare service utilization patterns and health care expenditures adopting the payer perspective.

AOK Bavaria Statutory Health Insurance Fund provided claims data for the years 2005 to 2007. All our analyses refer to 2006 and individuals were assigned to the case or the control group based on 2005 and 2006 diagnoses and anti-dementia drug prescriptions.

The baseline sample included all individuals continuously insured with AOK Bavaria during 2005 and 2006, who resided in Middle Franconia, and were born before 1941. Within this population we identified 9.147 people with assured dementia (incident and prevalent cases) and 2.893 individuals with potential dementia. The control group was drawn as a 1:4 random sample out of the remaining population with age and gender as matching criteria. Due to the high dementia prevalence in individuals aged 82 and older an exact 1:4 matching was not feasible. Thus only 29.741 non-demented individuals were included in the analyses.

Cost data for the case and the control group as well as for subpopulations of interest were evaluated in 2010 and 2011. Currently, a detailed analysis of service utilization patterns and characteristic comorbid conditions within the various subsamples is conducted.