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The cost of health care for dementia is greater than costs associated with any other disease, according to research published in Annals of Internal Medicine.
In the last 5 years of life, total healthcare spending for patients with probable dementia was $287,000 compared to $183,000 for other Medicare beneficiaries — 57% greater than costs for other diseases, including cancer and heart disease.
In order to calculate the social and monetary costs for the last 5 years of life for 1,702 Medicare fee-for-service beneficiaries (ages 70 and older) who died between 2005–2007, Amy S. Kelley, MD, of the Icahn School of Medicine at Mount Sinai, and colleagues analyzed data from the Health and Retirement Study, a nationally representative longitudinal study supported by the National Institute on Aging (NIA) and the Social Security Administration. They also examined Medicare and Medicaid records and other data.
The researchers calculated the costs from Medicare, Medicaid, private insurance, out-of-pocket, and informal care from specific categories of spending: insurance, hospital, physician, medication, nursing home, hired helpers, in-home medical care, and other expenses. They also calculated the out-of-pocket spending as a proportion of household wealth.
While the average Medicare expenses for dementia, cancer, heart disease, or another cause of death were similar, almost all other costs were higher for dementia. Medicaid costs for those with dementia averaged $35,346 compared with $4,552 for those without dementia; out-of-pocket spending for those with dementia was $61,522 compared with $34,068 for those without dementia; and informal care costs were estimated to be $83,022 for people with dementia compared with $38,272 for those without.
The financial burden was greater for those who were unmarried, had less than a high school education, and were African American. Single women with dementia also paid more out-of-pocket than married women with dementia.
“This complex analysis … provides an important picture of the risks that families face, particularly those with dementia and those who may be least able to bear major financial risk,” said Richard J. Hodes, MD, director of the NIA. “Such insights are critically important as we examine how best to support the aging of the U.S. population.”
