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Cost-effectiveness of one year dementia follow-up care by memory clinics or general practitioners: economic evaluation of a randomised controlled trial

Authors

Meeuwsen, Els, Melis, René, van der Aa, Geert, Golüke-Willemse, Gertie, de Leest, Benoit, van Raak, Frank, Schölzel-Dorenbos, Carla, Verheijen, Desiree, Verhey, Frans, Visser, Marieke, Wolfs, Claire, Adang, Eddy, Olde Rikkert, Marcel

Journal

Plos One, Volume: 8, No.: 11, Pages.: e79797-e79797

Year of Publication

2013

Abstract

Objective: To evaluate the cost-effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared to general practitioners’ care.; Methods: A multicentre randomised trial with 175 community dwelling patients newly diagnosed with mild to moderate dementia, and their informal caregivers, with twelve months’ follow-up. Cost-effectiveness was evaluated from a societal point of view and presented as incremental cost per quality adjusted life year. To establish cost-effectiveness, a cost-utility analysis was conducted using utilities based on the EQ-5D. Uncertainty surrounding the incremental cost-effectiveness ratio (difference in costs divided by difference in effects) was calculated by bootstrapping from the original data.; Results: Compared to general practitioners’ care, treatment by the memory clinics was on average €1024 (95% CI: -€7723 to €5674) cheaper, and showed a non-significant decrease of 0.025 (95% CI: -0.114 to 0.064) quality adjusted life years. The incremental cost-effectiveness point estimate from the bootstrap simulation was € 41 442 per QALY lost if one would use memory clinic care instead of general practitioner care.; Conclusion: No evidence was found that memory clinics were more cost-effective compared to general practitioners with regard to post-diagnosis treatment and coordination of care of patients with dementia in the first year after diagnosis.; Trial Registration: ClinicalTrials.gov NCT00554047.;

Bibtex Citation

@article{Meeuwsen_2013, doi = {10.1371/journal.pone.0079797}, url = {http://dx.doi.org/10.1371/journal.pone.0079797}, year = 2013, month = {nov}, publisher = {Public Library of Science ({PLoS})}, volume = {8}, number = {11}, pages = {e79797}, author = {Els Meeuwsen and Ren{'{e}} Melis and Geert van der Aa and Gertie Golüke-Willemse and Benoit de Leest and Frank van Raak and Carla Schölzel-Dorenbos and Desiree Verheijen and Frans Verhey and Marieke Visser and Claire Wolfs and Eddy Adang and Marcel Olde Rikkert}, editor = {John G. Meara}, title = {Cost-Effectiveness of One Year Dementia Follow-Up Care by Memory Clinics or General Practitioners: Economic Evaluation of a Randomised Controlled Trial}, journal = {{PLoS} {ONE}} }

Keywords

aged, aged, 80 and over, ambulatory care facilities, and, by, care, caregivers, clinics, coordination, dementia, economics, female, general practitioners, gps, humans, male, memory, of, quality of life, therapy

Countries of Study

Netherlands

Types of Dementia

Dementia (general / unspecified)

Types of Study

Economic evaluation, Randomised Controlled Trial

Type of Outcomes

Quality of Life of Person With Dementia, Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Settings

Primary Care, Specialist Dementia Centre Care / Memory Clinic

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Case management / Care navigator, Memory clinic / assessment centre