Abstract
Objective
The main aim of this paper is to give an overview on the quality of life, health care utilisation and costs of dementia in Hungary.
Method
A cross-sectional non-population based study of 88 consecutive dementia patients and their caregivers was conducted in three GP practices and one outpatient setting in 2008. Resource Utilization in Dementia (RUD), Mini Mental State Examination (MMSE) and quality of life (EQ-5D) were surveyed and cost calculations were performed. Costs of patients living at home were estimated by the current bottom-up cost-of-illness calculations, while costs of nursing home patients were considered by official reimbursement to determine the disease burden from a societal viewpoint.
Results
The mean age of the patients was 77.4 years (SD=9.2), 59% of them were female. The mean MMSE score was 16.70 (SD=7.24), and the mean EQ-5D score was 0.40 (SD=0.34). The average annual cost of dementia was 6,432 Euros per patient living at home and 6,086 Euros per patient living in nursing homes. For the whole demented population (based on EuroCoDe data) we estimated total annual costs of 846.8 million Euros; of which 55% are direct costs, 9% indirect costs and 36% informal care cost. Compared to acute myocardial infarction the total disease burden of dementia is 26.3 times greater.
Conclusions
This is the first study investigating resource utilisation, costs, and quality of life of dementia patients in the Central and Eastern European region. Compared to the general population of Hungary EQ-5D values of the demented patients are lower in all age groups. Dementia related costs are much lower in Hungary compared to Western European countries. There is no remarkable difference between the costs of demented patients living at home and in nursing homes, from the societal point of view.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Abbreviations
- AD:
-
Alzheimer's disease
- EuroCoDe:
-
European Collaboration on Dementia
- EQ-5D:
-
European Quality of life 5 Dimensions
- IADL:
-
Instrumental activity of daily living
- MCI:
-
Mild cognitive impairment
- PADL:
-
Physical activity of daily living
- MMSE:
-
Mini-Mental State Examination
- RUD:
-
Resource Utilization in Dementia
- SD:
-
Standard deviations
- NHIFA:
-
National Health Insurance Fund Administration
References
Brodszky V, Balint P, Geher P, Hodinka L, Horvath G, Koo E et al. Disease Burden of Psoriatic Arthritis Compared to Rheumatoid Arthritis, Hungarian Experiment. Rheum Int 2009;30(2):199–205
Minier T, Péntek M, Brodszky V, Ecseki A, Kárpáti K, Polgár A. Cost-of-illness of patients with systemic sclerosis in a tertiary care centre. Rheumatology. Doi: 10.1093/rheumatology/keq165
Péntek M, Kobelt G, Czirják L, Szekanecz Z, Poór G, Rojkovich B et al. Costs of rheumatoid arthritis in Hungary. J Rheumatol. 2007 Jun;34(6):1437
Gabányi J, Mónok G, Demencia diagnózisú kórházi esetek költségelemzése, OEP, 2003.
Falusi Zs, Gabányi J, Gulácsi L, A demencia epidemiológiája és költsége Magyarországon; jelenlegi helyzet és a várható trendek, Egészségügyi Gazdasági Szemle, 2004;43:1:50–58.
Kovács T., Bereczki D., Dementia: The Hungarian perspective, Corvinus Health Policy and Health Economics Miniconference November 12, 2009. http://http://hecon.uni-corvinus.hu/download/conferences/nov.12/K.Tibor_CorvinusAD_ea_KT.pdf Downloaded: 12.01.2010
Estimated number of people (2006) with dementia. Alzheimer Europe 2009 http://ec.europa.eu/health/ph_information/dissemination/echi/docs/dementia2_en.pdf Downloaded: 29.12.2009
Wimo A, Winblad B, Jönsson L. The worldwide societal costs of dementia: Estimates for 2009. Alzheimers Dement. 2010 Mar;6(2):98–103.
Wimo A, Jönsson L, Gustavsson A. Cost of illness and burden of dementia — The base option. Alzheimer Europe. http://www.alzheimer-europe.org/EN/Our-Research/European-Collaboration-on-Dementia/Cost-of-dementia/Cost-of-illnessand-burden-of-dementia Downloaded: 29.12.2009
Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr. 2007;44(1):71–81.
Jonsson L, Berr C. Cost of dementia in Europe. Eur J Neurol. 2005 Jun;12Suppl 1:50–53.
Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12Suppl 1:1–27.
SBU. Dementia. A systematic review. Stockholm: Staten beredning för medicinsk utvärdering (SBU) (The Swedish Council on Technology Assessment in Health Care) 2008. Report No.: 172E/1-3
Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005 Dec 17;366(9503):2112–2117.
Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, et al. Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000;54(11 Suppl 5):S4–S9.
Hofman A, Rocca WA, Brayne C, Breteler MM, Clarke M, Cooper B, et al. The prevalence of dementia in Europe: a collaborative study of 1980–1990 findings. Eurodem Prevalence Research Group. Int J Epidemiol. 1991 Sep;20(3):736–748.
Wimo A, Nordberg G, Jansson W, Grafström M. Assessment of informal services to demented people with the RUD instrument. Int J Geriatr Psychiatry. 2000;15(10):969–971.
Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr. 2007;44(1):71–81.
Guerrero-Berroa E, Luo X, Schmeidler J, Rapp MA, Dahlman K, Grossman HT, Haroutunian V, Beeri MS. The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly. Int J Geriatr Psychiatry. 2009;24(12):1429–1437.
Hungarian Central Statistical Office online database, www.ksh.hu
NHIFA online database, www.oep.hu
Hungarian Tax and Financial Control Administration database, http://en.apeh.hu/
National Audit Office Report Nr. 0820. Summary of the Audit of the Utilization of Funds Appropriated for Nursing by Hospitals and Residential Social Institutions of Local Governments (http://www.asz.hu/ASZ/www.nsf/reports.html)
Jonsson L, Lindgren P, Wimo A, Jonsson B, Winblad B. Costs of MMSE-related Cognitive Impairment. Pharmacoeconomics. 1999;16:409–416.
Szende A, Németh R. Health-related quality of life of the Hungarian population. Orv Hetil. 2003;144:1667–1674.
Wimo A, Jönsson L, Gustavsson A. Regional/National cost of illness estimates. Alzheimer Europe: http://www.alzheimer-europe.org/Our-Research/European-Collaboration-on-Dementia/Cost-of-dementia/Regional-National-cost-of-illnessestimates Downloaded: 29.12.2009
Gulácsi L, Májer I, Boncz I, Brodszky V, Merkely B, Maurovich Horváth P, Kárpáti K. Hospital costs of acute myocardial infarction in Hungary; 2003–2005. Orv Hetil. 2007;148(27):1259–1266.
Leél- ssy L, Sz cs I, Kindler M, Schwarz T. Incidence of Alzheimer pathology in the autopsy material of two hospitals (1996–1997) Clin. Neurosci./Ideggyogy Sz. 1998; 51/suppl. 1:34–35
Leél- ssy L, Kindler M, Sz cs I, Schwarcz T. Neuropathologic investigation in autopsies with special emphasis on findings in Alzheimer's disease. Clin. Neurosci./Ideggyogy Sz. 2006,. 59(5–6):164–177.
Kovács GG, Kovári V, Nagy Z. Frequency of different forms of dementia at the Department of Neuropathology of the Hungarian National Institute of Psychiatry and Neurology during a 3-year period. Clin Neurosci/ Ideggyogy. Sz. 2008;61(1–2) p. 24–32.
Leel- ssy, L. Incidence of Alzheimer's dementia in homes for the elderly. Arch Gerontol Geriatr. 1995;21(1):21–26.
Tariska P, Knolmayer J, Kiss é, Urbanics K, Mészáros á, Angyalosné Takó E, Mihocsa I, Baranyai Zs. The first Memory Clinic in Hungary: Experiences based on the data of the first five-year period. Clin Neurosci/ Ideggyogy Sz. 1998; 51/suppl 1.: 40–42.
Kálmán J, Boda K, Bende Z, Janka Z. Screening for dementia syndromes: the Hungarian experience with the 7-Minute-Test. Orv Hetil. 2003;144(39):1929–1938.
Tariska P, Paksy A. Mini-Cog: a simple method for very brief screening of mental decline. Orv Hetil. 2003;144(17):803–809.
Vincze G, Almos P, Boda K, Döme P, Bódi N, Szlávik G, Maglóczki E, Pákáski M, Janka Z, Kálmán J. Risk factors of cognitive decline in residential care in Hungary. Int J Geriatr Psychiatry. 2007;22(12):1208–1216.
Linka E, Kispál Gy, Szabó T, Bartkó Gy. A dementia sz rése és a betegek egyéves követése egy háziorvosi praxisban. Clin Neurosci/ Ideggyogy Sz. 2001. 54(5–6)
Leel- ssy L, Józsa I, Sz s I, Kindler M. Sz r vizsgálatok a dementia korai felderítésére (Családorvosi körzetekben és id sek otthonában). Medicus Universalis 2005. (3)
Érsek K, Kárpáti K, Kovács T, Csillik G, Gulácsi LÁ, Gulácsi L: Epidemiology of Dementia in Hungary. Clin. Neurosci./Ideggyogy. Sz. — 2010; 63(5–6): 175–182.
Pommer E, Woittiez I, Stevens J. Comparing Care. The care of the elderly in ten EU-countries. The Netherlands Institute for Social Research (SCP). Publication number: 2007/32.
Health, Ageing and Retirement in Europe. First Results from the Survey of Health, Ageing and Retirement in Europe (SHARE) Mannheim Research Institute for the Economics of Aging (MEA), 2005.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Érsek, K., Kovács, T., Wimo, A. et al. Costs of dementia in Hungary. J Nutr Health Aging 14, 633–639 (2010). https://doi.org/10.1007/s12603-010-0309-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-010-0309-1