reports

Population-level costs and resource utilization of homecare for persons with Alzheimer’s disease

J Popul Ther Clin Pharmacol 21:pe120.

Background: The aging population in Ontario is accompanied by an increased incidence and prevalence of Alzheimer’s disease (AD). Given this trend, the use of publicly-funded homecare services among persons with AD is rising. This requires an appropriate allocation of resources; however, detailed information on the use and relative costs of homecare for AD is limited.

Methods: The AD cohort was defined through the Ontario Drug Benefit Program as persons aged 65 years and older who were prescribed 1 of 3 cholinesterase inhibitors (i.e., galantamine, rivastigmine, or donepezil) between January 1st, 2004 and December 31st, 2006. Homecare utilization by this population was measured up to August 31st, 2011. Costs were obtained in 2009 dollars from Community Care Access Centres.

Results: A cohort of 78,410 individuals with AD were identified, 66.1% of which accessed publicly-funded homecare services during January 1, 2004 – August 31, 2011. For the 51,804 individuals who used homecare, a total of 10,089,721 services were delivered at a cumulative cost of $646,221,833 over the entire accrual period. The mean cost per individual over the entire time period was $12,474. Homemaking/personal support (8,534,973 claims; $336,961,323) were the most commonly reported homecare activities, followed by nursing (740,511 claims; $201,364,434) and case management (323,010 claims; $67,653,085).

Conclusions: The reported values are descriptive; a comparison with an age and resource utilization- matched control cohort is in progress. This will yield a cost attributable to the AD cohort defined here, segmented by phase of care.