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Open Access Research article

Private costs almost equal health care costs when intervening in mild Alzheimer's: a cohort study alongside the DAISY trial

Rikke Søgaard1*, Jan Sørensen1, Frans B Waldorff23, Ane Eckermann2, Dorthe V Buss2 and Gunhild Waldemar2

Author Affiliations

1 CAST - Centre for Applied Health Services Research and Technology Assessment, University of Southern Denmark, Denmark

2 The Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark

3 Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Denmark

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BMC Health Services Research 2009, 9:215  doi:10.1186/1472-6963-9-215

Published: 25 November 2009

Abstract

Background

Alzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide. Recent studies have evaluated the effect of early interventions for dementia, but few studies have considered private time and transportation costs associated with the intervention. This study assessed the total economic costs associated with a multifaceted intervention for mild Alzheimer's disease, including an estimate of the ratio of public to private costs.

Methods

The study sample comprised 163 dyads of patients and caregivers who received a multifaceted intervention of counselling sessions, courses and informational packages. The typical duration of the intervention was 7 months. A micro-costing approach was applied using prospectively collected data on resource utilisation that included estimates of participant time and transportation. Precision estimates were calculated using a bootstrapping technique and structural uncertainty was assessed with sensitivity analysis.

Results

The direct intervention cost was estimated at EUR 1,070 (95% CI 1,029;1,109). The total cost (including private costs) was estimated at EUR 2,020 (95% CI 1,929;2,106) i.e. the ratio of private to public costs was almost 1:1.

Conclusion

Intervention for mild Alzheimer's disease can be undertaken at a relatively low cost to public funds. However, policy planners should pay attention to the significant private costs associated with an intervention, which may ultimately pose a threat to equity in access to health care.

Trial registration

Current Controlled Trials ISRCTN74848736.