Share of and Absolute Costs of Informal Care in Five Subpopulations of Outpatients with Dementia in Croatia: A Latent Profile Analysis

Article type: Research Article

Authors: Sušac, Jelena^a | Vukojević, Jakša^a | Debogović, Siniša^a | Bajić, Žarko^b | Savić, Aleksandar^{a; c} | Đuran, Nataša^a | Hanževački, Miroslav^{d; *} | Vitezić, Dinko^{e; f} | Mimica, Ninoslav^{a; c}

Affiliations: [a] University Psychiatric Hospital Vrapče, Zagreb, Croatia | [b] Psychiatric Clinic Sveti Ivan, Zagreb, Croatia | [c] School of Medicine, University of Zagreb, Zagreb, Croatia | [d] General and Family Medicine Clinic, Health Center Zagreb-Zapad, Zagreb, Croatia | [e] School of Medicine, University of Rijeka, Rijeka, Croatia | [f] University Hospital Centre Rijeka, Rijeka, Croatia

Correspondence: [*] Correspondence to: Miroslav Hanževački, General and Family Medicine Clinic, Health Center Zagreb-Zapad, Zvonigradska 9, HR-10090 Zagreb, Croatia. Tel.: +385 98 980 4378; E-mail: miro.hanzevacki@yahoo.com.

Abstract: Background:High heterogeneity exists in estimates of the share of and absolute costs of informal care (IC) for individuals diagnosed with dementia. Objective:To assess the differences in the share of and absolute costs of IC between subpopulations defined by latent profiles of activities of daily living (ADLs), neuropsychiatric symptoms, and global cognitive functioning. Methods:We performed a nested cross-sectional analysis of data collected from 2019–2021 at the Zagreb-Zapad Health Center, Zagreb, Croatia, from a sample of patients and their caregivers. The outcome was the share of costs of IC in the total costs of care estimated using the Resource Utilization in Dementia questionnaire. We used latent profile analysis of six principal components of the Alzheimer’s Disease Cooperative Study ADLs inventory, Neuropsychiatric Inventory and Mini-Mental State Examination, and conducted the analysis using beta and quantile regression. Results:We enrolled 240 patients with a median age of 74 years; 78% were women. The annual cost for treatment and care for one patient was 11,462 (95% confidence interval 9,947; 12,976) EUR. After the adjustment for covariates, five latent profiles were significantly associated with the share of costs and absolute cost of IC. The adjusted annual costs of IC ranged from 2,157 EUR, with a share of 53% in the first latent profile, to 18,119 EUR, with a share of 78% in the fifth latent profile. Conclusion:The population of patients with dementia was heterogeneous, and there were relatively large differences in the share and absolute costs of IC between particular subpopulations.

Keywords: Alzheimer’s disease, cost of illness, dementia, informal care, latent profile analysis, resource utilization

DOI: 10.3233/JAD-230161

Journal: Journal of Alzheimer's Disease, vol. 94, no. 4, pp. 1417-1430, 2023