Financial Impact of Dementia Care on Thai Households: A Multicenter Study of Informal Care Costs and Contributing Factors
Author(s)
Juthamas Prawjaeng, PharmD.1, Pattara Leelahavarong, PhD.2, Khanit Pisawong, PharmD.2, varalak srinonprasert, MD2.
1Siriraj Health Policy Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand, 2Siriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.
1Siriraj Health Policy Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand, 2Siriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.
OBJECTIVES: To estimate direct non-medical (DNM) and out-of-pocket (OOP) costs of dementia care in Thailand and identify key cost drivers.
METHODS: A multicenter cross-sectional study was conducted in 2024 among 289 individuals with dementia or mild cognitive impairment (MCI) and their primary caregivers at five tertiary hospitals. DNM costs included informal care (valued using the replacement cost method), paid caregiving, and other non-medical expenses. OOP costs covered direct medical payments. Health-related quality of life (HRQoL) was assessed using proxy-reported EQ-5D-5L. Costs were compared by severity level, and generalized linear models (gamma distribution, log link) were used to identify predictors of total and informal care costs. All costs are reported in 2025 USD (1 USD = 32.58 THB).
RESULTS: The average annual DNM cost per person rose with dementia severity, from $9,328 (MCI) to $24,981 (severe dementia). Informal care was the largest DNM component, accounting for 71%-89% of the total, rising from $7,804 to $19,702, but slightly declining to $17,690 in severe cases due to increased paid caregiving. Annual OOP costs ranged from $116 to $335. Total annual costs (DNM + OOP) ranged from $9,444 (SD: $10,627) in MCI to $25,316 (SD: $15,991) in severe dementia. GLM analysis showed higher HrQoL was significantly associated with lower total cost (coefficient = -0.164, p = 0.032), but not with informal care. Paid care use increased total cost (coefficient = +0.436, p < 0.001). Caregiver age and care duration were also significant drivers.
CONCLUSIONS: Dementia care places a substantial financial burden on Thai households. Better HRQoL in early stages lowers total costs by reducing reliance on paid care, but informal caregiving needs remain consistently high. These findings support a national dementia policy that prioritizes early detection, community-based care, and structured caregiver support to delay disease progression and ease household costs as Thailand approaches an aged society.
METHODS: A multicenter cross-sectional study was conducted in 2024 among 289 individuals with dementia or mild cognitive impairment (MCI) and their primary caregivers at five tertiary hospitals. DNM costs included informal care (valued using the replacement cost method), paid caregiving, and other non-medical expenses. OOP costs covered direct medical payments. Health-related quality of life (HRQoL) was assessed using proxy-reported EQ-5D-5L. Costs were compared by severity level, and generalized linear models (gamma distribution, log link) were used to identify predictors of total and informal care costs. All costs are reported in 2025 USD (1 USD = 32.58 THB).
RESULTS: The average annual DNM cost per person rose with dementia severity, from $9,328 (MCI) to $24,981 (severe dementia). Informal care was the largest DNM component, accounting for 71%-89% of the total, rising from $7,804 to $19,702, but slightly declining to $17,690 in severe cases due to increased paid caregiving. Annual OOP costs ranged from $116 to $335. Total annual costs (DNM + OOP) ranged from $9,444 (SD: $10,627) in MCI to $25,316 (SD: $15,991) in severe dementia. GLM analysis showed higher HrQoL was significantly associated with lower total cost (coefficient = -0.164, p = 0.032), but not with informal care. Paid care use increased total cost (coefficient = +0.436, p < 0.001). Caregiver age and care duration were also significant drivers.
CONCLUSIONS: Dementia care places a substantial financial burden on Thai households. Better HRQoL in early stages lowers total costs by reducing reliance on paid care, but informal caregiving needs remain consistently high. These findings support a national dementia policy that prioritizes early detection, community-based care, and structured caregiver support to delay disease progression and ease household costs as Thailand approaches an aged society.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE466
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Geriatrics, Neurological Disorders