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Cost‐effectiveness analysis of English memory assessment services 2 years after first consultation for patients with dementia
Author(s) -
Gomes Manuel,
Pennington Mark,
Black Nick,
Smith Sarah
Publication year - 2019
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5036
Subject(s) - medicine , confidence interval , quality of life (healthcare) , observational study , referral , quality adjusted life year , cost effectiveness , dementia , eq 5d , physical therapy , health related quality of life , gerontology , disease , family medicine , risk analysis (engineering) , nursing
Objectives This paper aims to compare changes over 2 years in patients' health‐related quality of life (HRQL) with the health and social care costs of diagnosis and treatment of people newly referred to memory assessment services (MAS). Methods We analysed observational data from 1318 patients referred to 69 MAS who completed resource use and HRQL questionnaires at baseline 3, 6, 12, and 24 months. We reported mean differences in HRQL (disease‐specific DEMQOL and generic EQ‐5D‐3 L), quality‐adjusted life years (QALYs), costs and cost‐effectiveness between baseline, and 2‐year follow‐up. Results Two years after referral to MAS, patients reported a higher DEMQOL score (mean gain 4.47, 95% confidence interval, 3.08‐5.90) and EQ‐5D‐3 L (0.014, −0.011 to 0.039). Mean total costs and QALYs over 24 months was £2411 (£1721‐£2873) and 0.027 (0.003‐0.051), respectively. Assuming that patients' HRQL would not have altered over the 2 years had they not attended MAS, these outcomes suggest an incremental cost‐effectiveness ratio of £89 546 (£38 123‐£145 864) based on changes in EQ‐5D‐3 L. If we assumed that patients' HRQL would have declined by about 10% over this period had they not attended MAS, the cost‐effectiveness ratio would be £25 056. The largest MAS (N = 32; 46%) with over 50 new patients a month were more likely to be cost‐effective than smaller ones ( P < 0.01). Conclusions MAS are effective and can be cost‐effective for diagnosing and treating people with suspected dementia. Large variations in costs between clinics suggest that many MAS could improve their cost‐effectiveness.