PRIMARY CARE DEMENTIA CLINIC REDUCES SOCIETAL COST OF DEMENTIA- A COST-UTILITY ANALYSIS
Author(s)
Teo WK
National Healthcare Group, Singapore, Singapore
OBJECTIVES: The prevalence of dementia in Singapore is expected to increase with an ageing population. With the inclusion of dementia as part of Chronic Disease Management Program, more primary care consultations are expected in the polyclinic. A Primary Care Dementia Clinic (PCDC) was set up in Ang Mo Kio Polyclinic to manage stable patients. The objective of this study is to evaluate the cost-utility of dementia care at PCDC compared with specialists’ care at the Memory Clinic (MC) and care at other polyclinics. METHODS: Stable dementia patients with a Clinical Dementia Rating of 1.0 – 3.0 were recruited for the programme. Costs were measured from the societal viewpoint, including both direct and indirect costs. To establish cost-utility, EQ-5D was used to calculate QALYs. Cost and utility were measured at six-months and one-year. The incremental cost-effectiveness ratio was calculated by dividing the difference in costs by the difference in QALYs. RESULTS: A total of 168 dementia patients were recruited for this study. 55 for the PCDC arm and 113 from the two comparator groups (MC = 82 & Other Polyclinics = 31). Compared with care at the Memory Clinic and standard polyclinic care, PCDC was $2,110 (vs. MC) and $2,335 (vs. Other Polyclinics) lower respectively at six-months. There were no statistical differences in one-year costs and QALYs across both comparisons. CONCLUSIONS: Our analysis found that dedicated dementia care for stable patients at the primary care setting reduces societal cost. Expansion of PCDC could greatly reduce societal resources without impacting patients’ quality of life.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PMH30
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Mental Health, Neurological Disorders