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Cost effectiveness of non-drug interventions that reduce nursing home admissions for people living with dementia.

Jutkowitz E, Pizzi LT, Shewmaker P, Alarid-Escudero F, Epstein-Lubow G, Prioli KM, Gaugler JE, Gitlin LN. Cost effectiveness of non-drug interventions that reduce nursing home admissions for people living with dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2023 Sep 1; 19(9):3867-3893.

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Abstract:

INTRODUCTION: Six million Americans live with Alzheimer''s disease and Alzheimer''s disease and related dementias (AD/ADRD), a major health-care cost driver. We evaluated the cost effectiveness of non-pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD. METHODS: We used a person-level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence-based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer''s and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality-adjusted life years and incremental cost-effectiveness ratios. RESULTS: All four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1-way, 2-way, structural, and probabilistic sensitivity analyses. CONCLUSION: Dementia-care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non-pharmacologic interventions.




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