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The Use and Cost of Community Care Services by Elders with Unimpaired Cognitive Function, with Cognitive Impairment/No Dementia and with Dementia

Published online by Cambridge University Press:  29 November 2010

Evelyn Shapiro
Affiliation:
University of Manitoba
Robert B. Tate
Affiliation:
University of Manitoba

Abstract

Data from the Manitoba Study of Health and Aging were used to compare the utilization and direct costs of formal community care services among the elderly diagnosed as persons with no cognitive impairment, with cognitive impairment/no dementia and with dementia. The results of the analyses indicate that, in addition to living arrangement and limitation on basic and instrumental activities of daily living, mental function diagnosis is an independent predictor of community care use. A diagnosis of dementia increases the likelihood of community care use over those with unimpaired mental functioning, whereas cognitive impairment without dementia does not. The three diagnostic groups differ in the type of services used. Standardization by age, sex and the other variables which significantly affect the need for community care can help a program improve its ability to project realistic cost estimates.

Résumé

On a eu recours aux données d'une étude manitobaine sur la santé et le vieillissement (Manitoba Study of Health and Aging) pour comparer l'utilisation et le coût direct des soins communautaires structurés pour les aînés chez qui on a diagnostiqué une absence de déficience cognitive, une déficience cognitive sans démence ou une démence. Les résultats de l'analyse indiquent que, outre les conditions de logement et des incapacités dans les activités fondamentales et instrumentales de la vie quotidienne, un diagnostic de fonctionnement mental est un prédicteur indépendant de l'utilisation des soins communautaires. Une diagnostic de démence augmente la probabilité d'utilisation des soins communautaires chez les personnes qui en souffrent par rapport à celles qui en sont exemptes; par contre, la déficience cognitive sans démence ne l'augmente pas. Les trois types de diagnostic donnent lieu à une utilisation différente des soins. La standardisation par âge, sexe et toute autre variable affectant sensiblement la nécessité de recourir aux soins communautaires peut aider à la projection de coûts directs plus réalistes à l'égard d'un programme.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1997

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References

Altman, B.M., & Walden, D.C. (1993). Home health care: Use, expenditures and sources of payment (AHCPR Pub. No. 93–0040). National Medical Expenditure Survey Research Findings 15, Agency for Health Care Policy and Research. Rockville, MD: Public Health Service.Google Scholar
Campbell, A.J., McCosh, L.M., Reinken, J., & Allan, B.C. (1983) Dementia in old age and the need for services. Age and Ageing, 12, 1116.CrossRefGoogle ScholarPubMed
The Canadian Study of Health and Aging. (1994). Patterns of caring for people with dementia in Canada. Canadian Journal on Aging, 13(A), 470487.CrossRefGoogle Scholar
Canadian Study of Health and Aging Working Group. (1994). Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899913.Google Scholar
Coughlin, T.A., & Liu, K. (1989). Health care costs of older persons with cognitive impairments. The Gerontologist, 29(2), 173182.CrossRefGoogle ScholarPubMed
Hay, J.W., & Ernst, R.L. (1987). The economic costs of Alzheimer's Disease. American Journal of Public Health, 77(9), 11691175.CrossRefGoogle ScholarPubMed
Kruskall, W.H. (1952). A nonparametric test for the several sample problem. Annals of Mathematical Statistics, 23, 525540.CrossRefGoogle Scholar
Ostbye, T., & Crosse, E. (1994). Net economic costs of dementia in Canada. Canadian Medical Association Journal, 151(10), 14571464.Google ScholarPubMed
Penning, M.J. (1995). Cognitive impairment, caregiver burden, and the utilization of home health services. Journal of Aging and Health, 7(2), 233253.CrossRefGoogle ScholarPubMed
Rice, D.P., Fox, P.J., Max, W., Webber, P.A., Lindeman, D.A., Hauck, W.W., & Segura, E. (1993). The economic burden of Alzheimer's disease care. Health Affairs, Summer, 164176.CrossRefGoogle ScholarPubMed
Roth, M., Huppert, F., Tym, E., & Mountjoy, C. (1988). Camdex. The Cambridge examination for mental disorders of the elderly. Cambridge: Cambridge University Press.Google Scholar
Teng, E.L., & Chui, H.C. (1987). The Modified Mini-Mental State Examination. Journal of Clinical Psychiatry, 48, 314318.Google Scholar
Weinberger, M., Gold, D.T., Divine, G.W., Cowper, P.A., Hodgson, L.G., Schreiner, M.S., & George, L.K. (1993). Expenditures in caring for patients with dementia who live at home. American Journal of Public Health, 83(3), 338341.CrossRefGoogle ScholarPubMed
Wimo, A., Krakau, I., Mattsson, B., & Nelvig, A. (1994). The impact of cognitive decline and workload on the costs of dementia care. International Journal of Geriatric Psychiatry, 9, 479489.CrossRefGoogle Scholar