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Published on: September 30, 2020
Cost-effectiveness of the special care unit for persons with dementia
Ron Handels1, Bernhard Michalowsky2, Aline Mendes3
1Faculty of Health Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Dr. Tanslaan 12, P.O. box 6161, 6200 MD, Maastricht, the Netherlands; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Vägen 22, 171 64, Solna, Sweden.
Introduction:
We aimed to estimate the cost-effectiveness of the patient-centered special care unit for behavioral and psychological symptoms of dementia (SCU-B) in the Respectful Caring for the Agitated Elderly (RECage) study.
Methods:
A health-economic evaluation was performed alongside a controlled European multicenter three-year longitudinal cohort study enrolling 508 participants in a non-SCU-B cohort and SCU-B cohort. Health service resource use, costs, quality-adjusted life years (QALYs), and incremental cost per QALY gained were assessed.
Results:
Total QALYs were lower (-0.13; bootstrap-interval -0.23 to -0.02) and total costs were higher (€24,960; bootstrap-interval 14,870 to 35,090) in the SCU-B cohort. Base case and sensitivity analyses indicated the SCU-B was likely not cost-effective.
Discussion:
Widespread implementation as well as disinvestment of SCU-B cannot be recommended, given the uncertainty of the study results. We recommend a randomized study stratified by (local/county) region for conclusive evidence.
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