Is The Cost Of Dementia Care Really Higher Than Cancer And Heart Disease? A Surprising Look At The Numbers

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A report just published in the New England Journal of Medicine indicated that the costs associated with the care of patients with dementia were higher than that of cancer or heart disease. And, shockingly, the data presented showed that direct costs of care would increase from $109 million in 2010 to $259 million in 2040. This staggering increase was attributed to the increase in the elderly population, particularly baby boomers, and the rise in the rates of dementia.

The paper published in the New England Journal of Medicine compared 'current' costs of care for people with dementia to care for the population with heart disease and cancer, and got a result that was surprising. If you asked most people, after all, what the nation's biggest health problem was, they'd probably answer cancer or heart disease.

What is strange is that the authors chose to use calculations based on old data in order to obtain the total cost rather than actual numbers which have been gathered. 

What's stranger is that, if you take a closer look at the actual numbers, it turns out that heart disease is still far and away our nation's greatest medical issue — at least, from a financial perspective.

 

Understanding the Numbers

To begin, when compiling the cost of care for American dementia patients in 2010, the study investigators surveyed a group of elderly patients involved in ADAMS (Aging, Demographics, and Memory Study). By looking at 856 people over the age of 71 they determined the dementia prevalence for the entire United States.

The researchers then looked at 10,903 people in the parent study, HRS (Health and Retirement Study), in people over 70 to estimate the care costs for dementia based on costs of health services and use by the group. Then by using this data they were able to project the population in the U.S. that is affected by dementia, the cost per patient and the total cost of direct (and indirect) care costs for the entire country for 2010.

Investigators in the study then compared the total cost of care in 2010 ($109 billion) to the cost of care according to the Medical Expenditure Panel Survey (MEPS) for cancer and heart disease. Interestingly, in comparing 2010 dementia care costs the authors used MEPS 2008 data and converted the cost into 2010 dollars instead of using published MEPS 2010 data

The MEPS data for cancer and heart disease care costs for 2010 are publicly available, yet the researchers chose to compare estimated dementia costs from 2010 to cancer and heart disease care costs from 2008, adjusted for inflation in 2010 dollars.  The figures are higher in 2010 actual costs than in the 2008 inflation adjustments.

The Real Costs of Care

Additionally, looking at other data besides MEPS data paints a different picture of the cost comparisons for primary care.

For instance, a study published in January 2011 and cited by the National Cancer Institute puts 2010 care costs of cancer at $124.57 billion, far above the inflation adjusted $77 billion from 2008 cited in the present study, and higher than the actual 2010 MEPS data at $81.7 billion.

Similarly, the projections and actual care costs seem vastly different for heart disease for the US population. The current study indicates that heart disease costs according to MEPS data stands at "$96 billion in 2008, or $102 billion in 2010 dollars." The actual MEPS data for 2010 shows that heart disease care costs were over $107 billion. 

Furthermore, a study in the American Heart Association's journal, Circulation indicated that the medical costs for heart disease in 2010 (in 2008 dollars) was $273 billion. This is far above and beyond the amount ($109 billion) that was projected in the current study spent on dementia through out of pocket spending, Medicare costs and nursing. 

The estimated costs of heart disease medical costs will exceed $800 billion in 2030 (in 2008 dollars) according to the Circulation article. This is compared to the projected 2030 dementia cost, estimated in the current study to be at $183 billion.

Dementia will be a major source in the future of healthcare and care expenditures, especially with a rapidly aging population. 

Yet the media is broadly saying that "dementia costs are more than cancer or heart disease" when the data points to the fact that in overall costs and looking at other sources for comparison it is, and will continue to be, less of a total cost burden than cancer or heart disease. 

 

 

 

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