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Should we include dementia diagnosis or cognitive impairment to predict home care cost? An observational study using real-world data
Flurina Meier-Schwarzer, Nicole M Probst-Hensch, Marc Höglinger, Matthias Schwenkglenks, Simon Wieser. BMC Health Services Research, 2025-12-22
Topic: Risk, prevention and care in population studies
Among the 1,035 patients in our dataset, 176 (17%) had a dementia diagnosis. Mean monthly home care costs for dementia patients were CHF 362 (Swiss francs) higher (mean: CHF 1,082; median: CHF 812) than for non-dementia patients (mean: CHF 720; median: CHF: 457). ADL and IADL were the most important predictors of home care costs. Introducing dementia diagnosis or cognitive impairment or both alongside ADL, IADL, living alone, age and gender did not materially change prediction performance (AIC remains unchanged, BIC changes + 1.09 to + 6.36 in the main model). Our findings give no support for the implementation of differentiated reimbursement tariffs or risk adjustment models for dementia patients or patients with cognitive impairment. More general predictors, such as ADL and IADL impairments seem to predict home nursing care costs adequately enough. However, further research with larger and more representative samples in other countries is necessary to validate these findings. CLINICAL TRIAL NUMBER: Not applicable.
Key findings
- Among the 1,035 patients in our dataset, 176 (17%) had a dementia diagnosis.
- Mean monthly home care costs for dementia patients were CHF 362 (Swiss francs) higher (mean: CHF 1,082; median: CHF 812) than for non-dementia patients (mean: CHF 720; median: CHF: 457).
- ADL and IADL were the most important predictors of home care costs.
- Introducing dementia diagnosis or cognitive impairment or both alongside ADL, IADL, living alone, age and gender did not materially change prediction performance (AIC remains unchanged, BIC changes + 1.09 to + 6.36 in the main model).
- Our findings give no support for the implementation of differentiated reimbursement tariffs or risk adjustment models for dementia patients or patients with cognitive impairment.
Why it matters
This study examined whether including dementia diagnosis or cognitive impairment improves prediction of home care costs. It found these factors did not materially improve prediction beyond daily living measures, which concerns cost prediction rather than treating, curing or preventing Alzheimer's disease.
Study details
- Participants1,035
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 36 of the 96 points we could judge it on, which is 38 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC Health Services Research) |
| Journal's citation record | 2 / 4 | BMC Health Services Research: journal h-index 218 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,035 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Simon Wieser holds only 7 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | University of Basel: institution h-index 928 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41430206) |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 36 of the 96 points we could judge it on is 38 out of 100. |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s12913-025-13868-2
- PubMed: 41430206
- Original source →
- Free full text: BMC Health Services Research →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Meier-Schwarzer, F., Probst-Hensch, N. M., Höglinger, M., Schwenkglenks, M., & Wieser, S. (2025). Should we include dementia diagnosis or cognitive impairment to predict home care cost? An observational study using real-world data. BMC Health Services Research. https://doi.org/10.1186/s12913-025-13868-2
Vancouver
Meier-Schwarzer F, Probst-Hensch NM, Höglinger M, Schwenkglenks M, Wieser S. Should we include dementia diagnosis or cognitive impairment to predict home care cost? An observational study using real-world data. BMC Health Services Research. 2025. doi:10.1186/s12913-025-13868-2. PMID: 41430206.
BibTeX
@article{meierschwarzer2025-41430206,
author = {Meier-Schwarzer, Flurina and Probst-Hensch, Nicole M and Höglinger, Marc and Schwenkglenks, Matthias and Wieser, Simon},
title = {{Should we include dementia diagnosis or cognitive impairment to predict home care cost? An observational study using real-world data}},
journal = {BMC Health Services Research},
year = {2025},
doi = {10.1186/s12913-025-13868-2},
pmid = {41430206},
url = {https://doi.org/10.1186/s12913-025-13868-2}
}
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