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The Costs of Dementia From the Societal Perspective: Is Care Provided in the Community Really Cheaper Than Nursing Home Care?
König HH, Leicht H, Brettschneider C, Bachmann C, Bickel H, Fuchs A, Jessen F, Köhler M, Luppa M, Mösch E, Pentzek M, Werle J, Weyerer S, Wiese B, Scherer M, Maier W, Riedel-Heller SG (AgeCoDe Study Group). Journal of the American Medical Directors Association, 2014-02
Topic: Risk, prevention and care in population studies
This German study challenged the common assumption that keeping a person with dementia at home is always cheaper than nursing home care. Looking at total costs to society, including the value of unpaid family caregiving, community care was actually more expensive once the researchers accounted for how impaired patients were. The extra cost came almost entirely from the large amount of unpaid informal care that families provide at home.
Key findings
- Unadjusted annual societal costs were €29,930 (community) vs €33,482 (nursing home) per patient
- After adjusting for functional impairment and comorbidities, community care cost €11,344 (about $16,676) more per year than nursing home care
- The higher community-care cost was driven mainly by the value of unpaid informal caregiving
- Findings suggest that 'home care is cheaper' assumptions can reverse once informal caregiver time is properly costed
Why it matters
This German study found that, looking at total costs to society including the value of unpaid family caregiving, community care was actually more expensive than nursing home care once the researchers accounted for how impaired patients were. The extra cost came almost entirely from the large amount of unpaid informal care that families provide at home.
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Study details
- Study designcross-sectional
- Participants176
- Effect sizeUnadjusted annual costs were about €29,930 for community patients vs about €33,482 for nursing home residents; after adjusting for functional impairment and comorbidities, living in the community increased total costs by €11,344 (about $16,676), mainly due to higher informal care costs
- Evidence strengthModerate
Limitations
Small sample, especially for nursing home residents (n=48); the cross-sectional design cannot establish causality, and cost estimates depend heavily on the chosen method for valuing unpaid informal caregiver time.
How this study scored 52/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in 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 32 of the 62 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Medical Directors Association) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 176 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 32 / 62 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 32 of the 62 points we could judge it on is 52 out of 100. |
| Total | 52 / 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. The record names 16 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
König, H. H., Leicht, H., Brettschneider, C., Bachmann, C., Bickel, H., Fuchs, A., et al. (2014). The Costs of Dementia From the Societal Perspective: Is Care Provided in the Community Really Cheaper Than Nursing Home Care? Journal of the American Medical Directors Association.
Vancouver
König HH, Leicht H, Brettschneider C, Bachmann C, Bickel H, Fuchs A, et al. The Costs of Dementia From the Societal Perspective: Is Care Provided in the Community Really Cheaper Than Nursing Home Care? Journal of the American Medical Directors Association. 2014.
BibTeX
@article{konig2014-13a8e35b,
author = {König, H. H. and Leicht, H. and Brettschneider, C. and Bachmann, C. and Bickel, H. and Fuchs, A. and Jessen, F. and Köhler, M. and Luppa, M. and Mösch, E. and Pentzek, M. and Werle, J. and Weyerer, S. and Wiese, B. and Scherer, M. and Maier, W.},
title = {{The Costs of Dementia From the Societal Perspective: Is Care Provided in the Community Really Cheaper Than Nursing Home Care?}},
journal = {Journal of the American Medical Directors Association},
year = {2014}
}
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