Background There is growing evidence that the cost for dementia care will increase rapidly in the coming years. Therefore, the objective of this paper was to determine the economic impact of treating clients with dementia in outpatient Dementia Service Centres (DSCs) and simulate the cost progression with real clinical and cost data. Methods To estimate the cost for dementia care, real administrative and clinical data from 1341 clients of the DSCs were used to approximate the total cost of non-pharmaceutical treatment and simulate the cost progression with a discrete-time Markov chain (DTMC) model. The economic simulation model takes severity and progression of dementia into account to display the cost development over a period of up to ten years. Results Based on the administrative data, the total cost for treating these 1341 clients of the DSCs came to 67,294,910 EUR in the first year. From these costs, 74% occurred as indirect costs. Within a five-year period, these costs will increase by 7.1-fold (16.2-fold over 10 years). Further, the DTMC shows that the greatest share of the cost increase derives from the sharp increase of people with severe dementia and that the cost of severe dementia prevails the cost in later periods. Conclusion The DTMC model has shown that the cost increase of dementia care is mostly driven by the indirect cost and the increase of severity of dementia within any given year. The DTMC reveals also that the cost for mild dementia will decrease steadily over the time period of the simulation, whereas the cost for severe dementia increases sharply after running the simulation for 3 years.

中文翻译：

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痴呆症患者的护理成本：使用离散时间马尔可夫链方法以及来自奥地利痴呆症服务中心的管理和临床数据。

背景 越来越多的证据表明，痴呆症护理费用在未来几年将迅速增加。因此，本文的目的是确定在痴呆症门诊服务中心 (DSC) 治疗痴呆症患者的经济影响，并利用真实的临床和成本数据模拟成本进展。方法 为了估算痴呆症护理的成本，使用来自 DSC 1341 名客户的真实管理和临床数据来估算非药物治疗的总成本，并使用离散时间马尔可夫链 (DTMC) 模型模拟成本进展。经济模拟模型考虑了痴呆症的严重程度和进展，以显示长达十年的成本发展。结果 根据管理数据，第一年治疗 DSC 1341 名客户的总费用达到 67,294,910 欧元。在这些成本中，74% 是间接成本。五年内，这些成本将增加 7.1 倍（10 年内增加 16.2 倍）。此外，DTMC 显示，成本增加的最大部分来自于严重痴呆症患者的急剧增加，并且严重痴呆症的成本高于后期成本。结论 DTMC 模型显示，痴呆症护理成本的增加主要是由间接成本和任意一年内痴呆症严重程度的增加驱动的。DTMC 还透露，在模拟期间，轻度痴呆症的成本将稳步下降，而重度痴呆症的成本在模拟运行 3 年后急剧增加。