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A Break-Even Analysis for Dementia Care Collaboration: Partners in Dementia Care

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dc.contributor.authorMorgan, Robert O.
dc.contributor.authorBass, David M.
dc.contributor.authorJudge, Katherine S.
dc.contributor.authorLiu, C. F.
dc.contributor.authorWilson, Nancy
dc.contributor.authorSnow, A. Lynn
dc.contributor.authorPirraglia, Paul
dc.contributor.authorGarcia-Maldonado, Maurilio
dc.contributor.authorRaia, Paul
dc.contributor.authorFouladi, N. N.
dc.contributor.authorKunik, Mark E.
dc.contributor.otherUniversity of Texas Health Science Center Houston
dc.contributor.otherUniversity of Texas School Public Health
dc.contributor.otherCleveland State University
dc.contributor.otherUS Department of Veterans Affairs
dc.contributor.otherVeterans Health Administration (VHA)
dc.contributor.otherVet Affairs Puget Sound Health Care System
dc.contributor.otherUniversity of Washington
dc.contributor.otherUniversity of Washington Seattle
dc.contributor.otherBaylor College of Medicine
dc.contributor.otherUniversity of Alabama Tuscaloosa
dc.contributor.otherProvidence VA Medical Center
dc.contributor.otherBrown University
dc.contributor.otherAlzheimer's Association
dc.date.accessioned2023-09-28T19:04:46Z
dc.date.available2023-09-28T19:04:46Z
dc.date.issued2015
dc.description.abstractDementia is a costly disease. People with dementia, their families, and their friends are affected on personal, emotional, and financial levels. Prior work has shown that the "Partners in Dementia Care" (PDC) intervention addresses unmet needs and improves psychosocial outcomes and satisfaction with care. We examined whether PDC reduced direct Veterans Health Administration (VHA) health care costs compared with usual care. This study was a cost analysis of the PDC intervention in a 30-month trial involving five VHA medical centers. Study subjects were veterans (N = 434) 50 years of age and older with dementia and their caregivers at two intervention (N = 269) and three comparison sites (N = 165). PDC is a telephone-based care coordination and support service for veterans with dementia and their caregivers, delivered through partnerships between VHA medical centers and local Alzheimer's Association chapters. We tested for differences in total VHA health care costs, including hospital, emergency department, nursing home, outpatient, and pharmacy costs, as well as program costs for intervention participants. Covariates included caregiver reports of veterans' cognitive impairment, behavior problems, and personal care dependencies. We used linear mixed model regression to model change in log total cost post-baseline over a 1-year follow-up period. Intervention participants showed higher VHA costs than usual-care participants both before and after the intervention but did not differ significantly regarding change in log costs from pre- to post-baseline periods. Pre-baseline log cost (p a parts per thousand currency signaEuro parts per thousand 0.001), baseline cognitive impairment (p a parts per thousand currency signaEuro parts per thousand 0.05), number of personal care dependencies (p a parts per thousand currency signaEuro parts per thousand 0.01), and VA service priority (p a parts per thousand currency signaEuro parts per thousand 0.01) all predicted change in log total cost. These analyses show that PDC meets veterans' needs without significantly increasing VHA health care costs. PDC addresses the priority area of care coordination in the National Plan to Address Alzheimer's Disease, offering a low-cost, structured, protocol-driven, evidence-based method for effectively delivering care coordination.en_US
dc.format.mediumelectronic
dc.format.mimetypeapplication/pdf
dc.identifier.citationMorgan, R. O., Bass, D. M., Judge, K. S., Liu, C. F., Wilson, N., Snow, A. L., Pirraglia, P., Garcia-Maldonado, M., Raia, P., Fouladi, N. N., & Kunik, M. E. (2015). A Break-Even Analysis for Dementia Care Collaboration: Partners in Dementia Care. In Journal of General Internal Medicine (Vol. 30, Issue 6, pp. 804–809). Springer Science and Business Media LLC. https://doi.org/10.1007/s11606-015-3205-x
dc.identifier.doi10.1007/s11606-015-3205-x
dc.identifier.orcidhttps://orcid.org/0000-0002-0953-4215
dc.identifier.urihttps://ir.ua.edu/handle/123456789/10809
dc.languageEnglish
dc.language.isoen_US
dc.publisherSpringer
dc.subjectcosts and cost analysis
dc.subjectdementia
dc.subjectveterans
dc.subjectCASE-MANAGEMENT
dc.subjectINTERVENTION
dc.subjectCOSTS
dc.subjectVETERANS
dc.subjectOUTCOMES
dc.subjectPROGRAM
dc.subjectHealth Care Sciences & Services
dc.subjectMedicine, General & Internal
dc.titleA Break-Even Analysis for Dementia Care Collaboration: Partners in Dementia Careen_US
dc.typeArticle
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