engleski

Predicting risk of high healthcare costs in Alzheimer's patients - prospective cohort study

Introduction: A total of 44% of ali health care resources are spent on the care of patients affected with Alzheimer's disease. Published predictive models on highest ex- penses are based on univariate analyses of singular factors and on cross-sectional studies. Such studies feature a high risk of systematic errors. The objective of this research is to design and internally validated multivariate predictive model vvhich will simultanuously include ali seven proven modifiable risk factors for Alzheimer's disease, the patients' sociodemographic and socioeconomic characteristics, other chronic comorbidities and the severity of dementia, the ability to perform activities of daily living and behavioral symptoms, with the aim of predicting highest costs of formal and informal care and treatment. Hypothesis: Multivariate model ineluding diabetes, hypertension, obesity, depression, physical and cognitive inactivity, smoking and the result of the scale "Activities of Daily Living" (ADL) has greater predictive validity for highest costs of care and treatment of Alzheimer's disease than ADL scale alone. Aims: General aim is to establish statistical multivariate predictive model of the highest costs of formal care, informal care and treatment of patients diagnosed with Alzhei¬mer's disease Specific aims are: 1) determine the annual cost of informal care 2) determine the annual costs of formal care and treatment 3) compare the informal and formal costs 4) create a model for prediction of the high cost of health care 5) internal vali- dation of predictive models. Materials and methods: This is unicentric, observational, applied research (prospective cohort, prognostic study). The research will be conducted at the Health Center Zagreb Zapad for a period of six months. Target population are patients diagnosed with Alzheimer's disease who live in private households at the time of inelusion in the study, Estimated sample size is 205 patients (by two-stage, stratified random sampling). The main outeome is the upper quartile of the total cost of treatment for formal and infoh mal care. It will be measured by calculating the cost of formal medical and social cart and treatment at average prices and with Resource Utilization in Dementia (RUD) questionnaire. Expected scientific contribution: This research may contribute to understanding Interrelationship of risk factors for the hlgh cost of health care of patients with Alzheimer's disease. Such model can be valuable for better allocation of healthcare resources.

Azheimer's disease; costs; predictive model

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