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. 2015 Jan-Mar;9(1):32-41.
doi: 10.1590/S1980-57642015DN91000006.

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

Nilton Custodio  1   2   3 , David Lira  1   2   3 , Eder Herrera-Perez  2   4 , Liza Nuñez Del Prado  5   2   3 , José Parodi  6 , Erik Guevara-Silva  7 , Sheila Castro-Suarez  5   2   3   8 , Rosa Montesinos  5   2   9
Affiliations

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

Nilton Custodio et al. Dement Neuropsychol. 2015 Jan-Mar.

Abstract
in English, Portuguese

Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries.

Objective: The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru.

Methods: We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs).

Results: In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US$ 23 over three months, demented patients had costs of US$ 1500 or over (and more than US$ 1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US$ 570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US$ 222.22).

Conclusion: Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patient's family.

Demência é uma das principais causas de dependência e incapacidade entre idosos, e impõe enormes encargos econômicos. Apenas alguns estudos de custo-de-doença para a demência foram realizados em países de renda média e baixa.

Objetivo: O objetivo deste estudo foi analisar os custos relacionados com demência em pacientes de uma clínica particular, em Lima, Peru.

Métodos: Foi realizado estudo retrospectivo de uma coorte durante três meses para extrair informações de prontuários de pacientes com demência para avaliar a utilização de recursos tanto de saúde como outros. Os custos totais da doença foram divididos em diretos (despesas de assistência médica e social) e indiretos (custos de cuidados informais).

Resultados: Em 136 pacientes ambulatoriais, observou-se que, enquanto metade dos pacientes não dementes teve custos totais de cuidados de menos de US$ 23 ao longo de três meses, os pacientes dementes tiveram custos de US$ 1500 ou mais (e mais de US$ 1.860 para a demência frontotemporal). Em nosso estudo, o custo mensal de um paciente demente (US$ 570) foi 2,5 vezes maior do que o salário mínimo (salário mínimo mensal no Peru em 2011: US$ 222,22).

Conclusão: Demência constitui um problema socioeconômico, mesmo nos países em desenvolvimento, uma vez que os pacientes envolvem altos custos de saúde e não de saúde, com os custos sendo especialmente altos para a família do paciente.

Keywords: cost of illness; costs and cost analysis; dementia; health care costs; health expenditures.

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Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution map of poverty in Lima City, Peru. The colors refer to level of poverty as following: very high incomes (purple); high incomes (yellow); middle incomes (orange); low incomes (brown); and very low incomes (red). The red circle indicates the location of the International Clinic.
See this image and copyright information in PMC

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