Cost-effectiveness of the special care unit for persons with dementia.
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.
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.
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.
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.
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.
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.
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.
Authors
Handels Handels, Michalowsky Michalowsky, Mendes Mendes, Bergh Bergh, Cesana Cesana, Ciccone Ciccone, Cognat Cognat, Fabbo Fabbo, Fascendini Fascendini, Frisoni Frisoni, Froelich Froelich, Mecocci Mecocci, Merlo Merlo, Peters Peters, Tsolaki Tsolaki, Defanti Defanti,
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