1 November 2011
There has been extensive media coverage recently of the findings of Luengo-Fernandez et al. (2011). Dementia is indeed a costly condition. But, from examining the Supplementary Data (http://www.j-alz.com/issues/27/luengo_supplement.pdf), is it possible that the cost has been over-estimated?
Firstly, was comorbidity and impairment not caused by dementia fully accounted for in estimating social care costs, given that dementia patients often have other conditions requiring care? If, say, a 90-year-old with osteoarthritis, heart failure, and impaired vision would have been able to cope at home with £300 worth of care per week, but because she also had dementia needed to be in a residential home at a cost of £800 per week, would the cost of dementia be calculated as £500 rather than the full £800?
Secondly, with regard to the cost of informal care, when ‘The time spent by relatives and friends providing unpaid care for dementia sufferers was obtained from country-specific studies evaluating the informal care patterns of dementia patients... The average hours of informal care given to each dementia patient was then multiplied by the number of people with dementia living in the community and annualized’, was sufficient account taken of the fact that such studies focus on those receiving care for dementia, while many (especially with mild dementia) do not receive informal or formal care and may not even be diagnosed?
Thirdly, with regard to outpatient visits, did the methodology used result in an excessive figure? In the team’s UK-based study ‘Dementia 2010: the economic burden of dementia and associated research funding in the United Kingdom’ (http://www.dementia2010.org/reports/Dementia2010Full.pdf), it was estimated that in 2006 there were 489,766 outpatient consultations for dementia, but this appears many times greater than the figure in the NHS Information Centre’s Hospital Episode Statistics for outpatient attendances in England (where the majority of the UK population lives) in 2006-7 (Primary diagnosis, 2006-07, Excel file).
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