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The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life
Kelley AS, McGarry K, Gorges R, Skinner JS. Annals of Internal Medicine, 2015-11-17
Topic: Risk, prevention and care in population studies
This study followed a national sample of Medicare beneficiaries who died and compared total health and long-term care spending in their final five years of life. People with dementia had far higher total costs, about $287,000 on average, than people who died of heart disease, cancer, or other causes, and their families paid far more out of pocket. Black families, less-educated families, and unmarried women bore an especially heavy share of that burden.
Key findings
- Average total cost per dementia decedent was $287,038 over the last 5 years of life, higher than for heart disease, cancer, or other causes
- Out-of-pocket spending for dementia decedents was $61,522, 81% higher than for non-dementia decedents
- Out-of-pocket costs consumed 32% of household wealth for dementia families versus 11% for non-dementia families
- The financial burden fell disproportionately on Black families, those with less than a high school education, and unmarried/widowed women
Why it matters
Average total health care costs in the last five years of life were substantially larger for people with dementia than for those who died of heart disease, cancer, or other causes. Much of this spending was uncovered, placing a large financial burden on households.
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Study details
- Study designcohort
- Participants1,702
- Effect sizeAverage total cost per dementia decedent was $287,038 vs $175,136 (heart disease), $173,383 (cancer), and $197,286 (other causes) [P<.001]; out-of-pocket spending for dementia decedents was $61,522, 81% higher than for non-dementia decedents ($34,068)
- Evidence strengthHigh
Limitations
Dementia status was determined by proxy-reported survey/cognitive measures rather than clinical diagnosis, and the cohort of deaths (2005-2010) predates more recent changes in long-term care financing and dementia diagnosis patterns.
How this study scored 66/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded and indexed in PubMed because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 41 of the 62 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of Internal Medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,702 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 0 / 2 | No PubMed ID and no DOI — scores zero (not stated in the record — scored 0) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 41 / 62 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 41 of the 62 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. This record has no DOI, so the citation leaves it out. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Kelley, A. S., McGarry, K., Gorges, R., & Skinner, J. S. (2015). The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life. Annals of Internal Medicine.
Vancouver
Kelley AS, McGarry K, Gorges R, Skinner JS. The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life. Annals of Internal Medicine. 2015. PMID: 26502320.
BibTeX
@article{kelley2015-ed40db3a,
author = {Kelley, A. S. and McGarry, K. and Gorges, R. and Skinner, J. S.},
title = {{The Burden of Health Care Costs for Patients With Dementia in the Last 5 Years of Life}},
journal = {Annals of Internal Medicine},
year = {2015},
pmid = {26502320}
}
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