Caring for People with Dementia: A Comparison between Dementia and Other Health Conditions

Studies show an increasing number of dementia patients incur higher costs than individuals with other health conditions. The majority of these costs relate to care. Given recent government reforms that have moved toward patient centred care, we can expect private organisations to play a greater role in the care market. An understanding of the use of care services by individuals with a dementia condition along with the associated costs of care will inform policy makers and private organisations in the subsiding and planning of services.

This study aims to estimate how much more care – either from organisations, family or establishments – an individual with dementia receives compared to individuals experiencing other health conditions. Additionally, this study sought to quantify the additional yearly private expenditures of care per dementia person compared to other health conditions.

Data were sourced from 2015 Survey of Disability, Ageing and Carers (SDAC), a large representative population dataset from the Australian Bureau of Statistics. The inclusion of client information such as level of disability provides a more meaningful examination of the cost of care services. Initially the quantity of care for each main health condition (dementia/Alzheimer, cancer, diabetes, circulatory, respiratory, musculoskeletal, mental) by care type is estimated. Further analysis that controlled for confounding variables estimated how much more care is needed for individuals experiencing a dementia condition compared to those experiencing another health condition. Cost of care estimates was based on the information derived from the regression analysis that controlled for confounding variables. Later the probability of entering aged care facilities was estimated for individuals with a dementia condition relative to individuals with other health conditions.

Compared to individuals experiencing health conditions other than dementia, a smaller proportion with a dementia condition received home care services and a greater proportion resided in establishments. When controlling for characteristics such as age, gender, and severity of condition, the analysis revealed that the average frequency of organised home care services received per year by individuals with dementia was between 44 and 56 more visits compared to those experiencing other health conditions. The frequency of family assistance received by individuals with dementia was between 73 and 139 more per year than individuals with other health conditions. The odds of entering establishments was 8.5 times greater for people experiencing a dementia condition compared to those experiencing other types of health conditions. For an individual with a dementia condition residing in the community the combined average value of care was conservatively estimated to be around $5000 per year above other health conditions.

The nature of the dementia illness itself has a significant and substantial association with the frequency of care at home. The greater reliance by individuals with dementia on care at home appears to increase their likelihood of residing in establishments. The authors support a dementia home care subsidy that reflects the true cost of care experienced by dementia households. An appropriately costed subsidy will improve quality of life and contain costs by incentivising families to seek diagnosis and treatment earlier.