[Estimated health care expenditures for 'demented' patients]

The authors try to give a cost containment analysis of the health care costs spent on patients labelled as suffering from dementia (presenile, senile dementia, Alzheimer's disease, organic psychotic conditions, arteriosclerotic dementia, depressive and paranoid dementia and others). Due to the difficulties in defining dementia, only a rough impression of the costs can given. The total costs of intramural care in 1977-1978 were about of f 912,9 million/year ($ 456,4 million). Intramural care in the Netherlands includes general hospitals, psychiatric hospitals and nursing homes (longstay annexes) with a psychogeriatric ward. This is about 7% of all costs spent on intramural care in the Netherlands. Extramural, ambulatory care was estimated circa f 274 million ($ 137 million) and daycare centres in nursinghomes on f 2 million ($ 1 million). Extramural care is given by general practitioners, ambulant social psychogeriatric teams and community services delivered by public health nurses. The estimated total costs were circa f 1189 million ($ 594 million) or about 5% of the total costs spent on health care/year which is f 761 ($ 380)/elderly person and 0,4% of the national income. In contrast the expenses on scientific research in gerontology in the Netherlands--especially in the field of dementia--are almost nil. Dementia needs more attention than it receives today.