1. The economic impact of moderate stage Alzheimer's disease in Italy: Evidence from the UP-TECH randomized trial
- Author
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Chiatti, C., Furneri, G., Rimland, J. M., Demma, F., Bonfranceschi, F., Cassetta, L., Masera, F. b, Cherubini, Corsonello, A., Lattanzio, F., Baldassarri, D., Bitti, L., Carosi, A., Sabbatini, M., Paolasini, E., Fiori, T., Fronzi, C., Giacchetta, S., Giacomini, V., Giovagnoli, L., Lattanzi, G., Manca, A. M., Marinelli, I., Pigini, V., Pignotti, M., Proietti, M. C., Quarticelli, A., Rovedi, M., Tasso, L., Valeri, V., Antonioli, A., Barabucci, M., Bassani, M., Bollettini, P., Bruttapasta, M. C., Buccolini, C., Carangella, R., Carboni, F., Ceccolini, D., D'Incecco, P., Di Felice, M., Dini, L., Gioia, G., Di Prima, G., Giusepponi, G., Lanciotti, C., Loffreda, A., Luciani, O., Mariani, L., Mastrorilli, F., Moroni, R., Piatkowska, I., Rucoli, R., Scoccia, G., Teodori, N., Tonelli, T., Angeloni, R., Bratti, R. A., Bonafede, G., Lorenzetti, S., Paci, C., Picciotti, G., Pezzola, D., Rea, V., Scialè, V., Signorino, M., Sorvillo, F., Tomassini, P. F., Ciccola, A., Cionfrini, L., Alessandrini, D., De Santis, A., Formica, B., Tacchi, G., Tortorelli, S., Marchegiani, G., Pozzari, G., Santarelli, G., Bartolucci, D., Caraffa, G., Cavallo, Filippo, Di Furia, L., Lacetera, A., Maffei, C. M., Manzoli, L., Postacchini, D., Bevilacqua, R., Bonfigli, A. R., Bustacchini, S., Capasso, M., Civerchia, P., Di Rosa, M., Giuli, C., Marcellini, M., Marinelli, P., Melchiorre, G., Moraca, M. E., Principi, A., Rocchetti, C., Spazzafumo, L., Vincitorio, D., Bartulewicz, K., Olivetti, P., and Rossi, L.
- Subjects
Gerontology ,Male ,very elderly ,cost of illness ,Public expenditure ,morbidity ,residential care ,community care ,Italian (citizen) ,cost analysis ,Surveys and Questionnaires ,Health care ,Activities of Daily Living ,80 and over ,Medicine ,organization and management ,caregiver ,media_common ,Aged, 80 and over ,Public sector ,Mini Mental State Examination ,aged ,Alzheimer disease ,Article ,controlled study ,daily life activity ,disease severity ,economic aspect ,female ,health care ,health care cost ,human ,Italy ,major clinical study ,mortality ,physical performance ,prescription ,prevalence ,randomized controlled trial ,scoring system ,social care ,socioeconomics ,welfare ,economics ,male ,quality of life ,questionnaire ,statistical model, Activities of Daily Living ,Aged ,Alzheimer Disease ,Caregivers ,Cost of Illness ,Female ,Health Expenditures ,Humans ,Linear Models ,Quality of Life ,Alzheimer's disease ,community-living ,RCT ,UP-TECH ,Psychiatry and Mental health ,Clinical Psychology ,Alzheimer’s disease ,media_common.quotation_subject ,Quality of life (healthcare) ,Dementia ,Medical prescription ,Socioeconomic status ,business.industry ,statistical model ,medicine.disease ,Geriatrics and Gerontology ,business ,Welfare - Abstract
Background:There is consensus that dementia is the most burdensome disease for modern societies. Few cost-of-illness studies examined the complexity of Alzheimer's disease (AD) burden, considering at the same time health and social care, cash allowances, informal care, and out-of-pocket expenditure by families.Methods:This is a comprehensive cost-of-illness study based on the baseline data from a randomized controlled trial (UP-TECH) enrolling 438 patients with moderate AD and their primary caregiver living in the community.Results:The societal burden of AD, composed of public, patient, and informal care costs, was about €20,000/yr. Out of this, the cost borne by the public sector was €4,534/yr. The main driver of public cost was the national cash-for-care allowance (€2,324/yr), followed by drug prescriptions (€1,402/yr). Out-of-pocket expenditure predominantly concerned the cost of private care workers. The value of informal care peaked at €13,590/yr. Socioeconomic factors do not influence AD public cost, but do affect the level of out-of-pocket expenditure.Conclusion:The burden of AD reflects the structure of Italian welfare. The families predominantly manage AD patients. The public expenditure is mostly for drugs and cash-for-care benefits. From a State perspective in the short term, the advantage of these care arrangements is clear, compared to the cost of residential care. However, if caregivers are not adequately supported, savings may be soon offset by higher risk of caregiver morbidity and mortality produced by high burden and stress. The study has been registered on the website www.clinicaltrials.org (Trial Registration number: NCT01700556).
- Published
- 2015