Anticipated Social and Healthcare Economic Burden of People with Alzheimer’s Disease in Two Selected Regions of the Czech Republic
Abstract
:1. Introduction
2. Theoretical Background
3. Methodology
3.1. Study Design
- A population model for predicting the number of people with AD between 2020 and 2070;
- A cost model for calculating the economic burden between 2020 and 2070 based on the predicted number of people with AD from the population model.
3.2. Population Model and Data Sources
3.3. Cost Model and Data Sources
- Outpatient care—outpatient procedures administered by primary care medical doctors and specialists;
- Costs of medicines in outpatient clinics and hospitals (residential facility);
- Costs of hospital services;
- Hospitalisation—emergency care as well as other care.
- People in the mild stage are mostly at home and are cared for by informal caregivers;
- Moderate-stage patients are also predominantly at home and use outpatient and domiciliary social services more often but there is a capacity problem, meaning many of them are unable to use these services;
- Patients suffering from the severe stage could be in residential social care facilities, but there is a capacity problem, meaning many of them cannot use these social services.
4. Results
4.1. Population of People with AD
4.2. Direct Costs
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Region | Number of 65+ | Percentage of 65+ | ||||||
---|---|---|---|---|---|---|---|---|
2020 | 2030 | 2050 | 2070 | 2020 | 2030 | 2050 | 2070 | |
KHK | 119,380 | 132,425 | 158,148 | 141,309 | 21.7 | 24.4 | 31.0 | 29.9 |
VYS | 104,649 | 120,262 | 147,689 | 130,291 | 20.5 | 24.3 | 31.9 | 30.6 |
Variable | Structure | Input Data | Initial Phase Description |
---|---|---|---|
Population size | Matrix 96 × 53 (96 age cohorts: 0–95+; 53 years: 2019–2071) | [40] | Population for regions from 2019 (the Czech Statistical Office data). For each region, there is a specific dataset with the same structure. |
Prevalence AD | 31 values (from 65 to 95+) | [42,44] | Based on the values for the EU, see Figure 1. |
Incidence AD | 31 values (from 65 to 95+) | [39] | Derived from AD prevalence, see Figure 1. |
Transition probabilities | Matrix 4 × 4 (3 stages and death) | [43] | The transition probabilities between the disease stages (Figure 2). |
Individual stage proportions | 3 values (mild, moderate, severe) | Limit Distribution | Initial division of patients into individual stages. |
Costs | Data Source | Stage Identification | Year(s) |
---|---|---|---|
Medical | Institute of Health Information and Statistics of the Czech Republic | According to Mini Mental State Exam (MMSE) within age cohorts | 2017 |
Non-medical | Webpages of the regional governments | Based on expert estimates from personal meetings | 2019–2020 |
Questionnaire [45] for social service providers | 2019 |
KHK | Outpatient | Inpatient | |||||
---|---|---|---|---|---|---|---|
Stage | Age Cohort | “Point” System | Other Services | Medicines | “Point” System | Acute Care | Other Care |
Mild | 65–69 | 435.77 | 31.77 | 72.00 | 0.00 | 243.42 | 442.54 |
70–79 | 268.15 | 34.35 | 22.35 | 0.00 | 236.88 | 489.04 | |
80–89 | 187.77 | 15.23 | 33.35 | 0.00 | 264.69 | 574.23 | |
90+ | 164.85 | 6.27 | 3.35 | 0.00 | 263.15 | 976.08 | |
Moderate | 65–69 | 227.35 | 23.46 | 77.27 | 0.00 | 166.77 | 557.00 |
70–79 | 212.31 | 24.12 | 9.46 | 0.00 | 291.65 | 772.62 | |
80–89 | 182.96 | 13.08 | 50.15 | 0.15 | 242.38 | 506.92 | |
90+ | 154.69 | 10.19 | 5.54 | 0.00 | 125.00 | 0.00 | |
Severe | 65–69 | 188.42 | 52.58 | 25.58 | 0.00 | 170.04 | 356.77 |
70–79 | 213.77 | 21.85 | 294.54 | 0.00 | 307.88 | 685.92 | |
80–89 | 161.15 | 11.81 | 9.00 | 0.00 | 298.85 | 715.96 | |
90+ | 120.42 | 8.35 | 7.65 | 0.00 | 224.54 | 891.38 |
VYS | Outpatient | Inpatient | |||||
---|---|---|---|---|---|---|---|
Stage | Age Cohort | “Point” System | Other Services | Medicines | “Point” System | Acute Care | Other Care |
Mild | 65–69 | 244.69 | 30.85 | 454.62 | 0.00 | 316.85 | 586.85 |
70–79 | 232.23 | 19.54 | 75.58 | 0.00 | 194.00 | 453.85 | |
80–89 | 251.15 | 12.00 | 14.19 | 0.00 | 260.92 | 711.69 | |
90+ | 157.42 | 6.54 | 7.08 | 0.00 | 308.73 | 668.38 | |
Moderate | 65–69 | 194.35 | 24.38 | 1.85 | 0.00 | 107.42 | 761.92 |
70–79 | 202.00 | 19.12 | 5.92 | 0.00 | 167.58 | 708.12 | |
80–89 | 201.35 | 8.65 | 3.92 | 0.00 | 193.62 | 722.12 | |
90+ | 187.04 | 13.50 | 4.54 | 0.00 | 263.73 | 868.12 | |
Severe | 65–69 | 185.35 | 25.23 | 2.73 | 0.00 | 187.19 | 647.42 |
70–79 | 210.12 | 18.42 | 41.81 | 0.00 | 215.08 | 531.62 | |
80–89 | 261.31 | 9.08 | 12.58 | 0.00 | 257.73 | 832.12 | |
90+ | 157.92 | 3.23 | 19.58 | 0.00 | 276.35 | 987.19 |
Region | KHK | VYS | ||||
---|---|---|---|---|---|---|
Residential Services | Capacity (beds) | For AD (%) | Unit Cost (EUR) | Capacity (beds) | For AD (%) | Unit Cost (EUR) |
Respite Care | 67 | 78 | 44.65 | 39 | 78 | 71.15 |
Week Care Centres | 9 | 47 | 45.58 | 0 | 47 | 76.92 |
Homes for the Elderly | 2019 | 17 | 39.77 | 1977 | 20 | 51.92 |
Special Regime Homes | 447 | 90 | 44.73 | 812 | 80 | 53.85 |
Health Care Facilities | 34 | 47 | 23.77 | 57 | 47 | 33.08 |
Region | KHK | VYS | ||||
---|---|---|---|---|---|---|
Outpatient & Domiciliary Services | Capacity (FTE) | For AD (%) | Unit Cost (EUR) | Capacity (FTE) | For AD (%) | Unit Cost (EUR) |
Personal Assistance | 82 | 50 | 1605.96 | 83 | 50 | 1961.54 |
Day Services Centres | 8 | 50 | 2184.31 | 23 | 50 | 2153.85 |
Daycare Centres | 31 | 50 | 1681.62 | 117 | 50 | 2153.85 |
Domiciliary Service | 412 | 50 | 1804.54 | 405 | 50 | 1961.54 |
Respite Care | 0 | 78 | 0.00 | 25 | 78 | 2346.15 |
Costs/Year | 2020 | 2030 | 2040 | 2050 | 2060 | 2070 |
---|---|---|---|---|---|---|
KHK Region | 25.636 | 40.288 | 51.384 | 57.263 | 64.425 | 69.018 |
Medical | 4.289 | 6.866 | 8.589 | 9.592 | 10.695 | 11.245 |
Non-medical | 21.347 | 33.422 | 42.795 | 47.671 | 53.730 | 57.773 |
VYS Region | 38.484 | 61.034 | 78.587 | 90.674 | 102.025 | 107.983 |
Medical | 3.977 | 6.441 | 8.229 | 9.490 | 10.683 | 11.184 |
Non-medical | 34.508 | 54.593 | 70.358 | 81.184 | 91.342 | 96.799 |
Stage | Mild | Moderate | Severe | No Resolution | ||||
---|---|---|---|---|---|---|---|---|
Direct Costs | KHK | VYS | KHK | VYS | KHK | VYS | KHK | VYS |
Medical | 359 | 354 | 298 | 389 | 1624 | 1671 | 482 | 504 |
Non-medical | 2330 | 4229 | 2330 | 4229 | 2330 | 4229 | 2330 | 4229 |
Total | 2689 | 4583 | 2628 | 4618 | 3954 | 5900 | 2812 | 4733 |
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Share and Cite
Maresova, P.; Komarkova, L.; Kuhnova, J.; Cimler, R.; Pazitny, P.; Kandilaki, D.; Musilek, K.; Truhlarova, Z.; Zemek, F.; Kuca, K. Anticipated Social and Healthcare Economic Burden of People with Alzheimer’s Disease in Two Selected Regions of the Czech Republic. Healthcare 2020, 8, 433. https://doi.org/10.3390/healthcare8040433
Maresova P, Komarkova L, Kuhnova J, Cimler R, Pazitny P, Kandilaki D, Musilek K, Truhlarova Z, Zemek F, Kuca K. Anticipated Social and Healthcare Economic Burden of People with Alzheimer’s Disease in Two Selected Regions of the Czech Republic. Healthcare. 2020; 8(4):433. https://doi.org/10.3390/healthcare8040433
Chicago/Turabian StyleMaresova, Petra, Lenka Komarkova, Jitka Kuhnova, Richard Cimler, Peter Pazitny, Daniela Kandilaki, Kamil Musilek, Zuzana Truhlarova, Filip Zemek, and Kamil Kuca. 2020. "Anticipated Social and Healthcare Economic Burden of People with Alzheimer’s Disease in Two Selected Regions of the Czech Republic" Healthcare 8, no. 4: 433. https://doi.org/10.3390/healthcare8040433