Predviđanje rizika visokih troškova zdravstvene zaštite bolesnika s Alzheimerovom bolešću

doctoral thesis

• Title (english): Predicting the risk of high healthcare costs for patients with Alzheimer's disease
• Author: Jelena Sušac
• Mentor: Ninoslav Mimica (mentor)
• Mentor: Dinko Vitezić (komentor)
• Committee member: Goran Šimić (predsjednik povjerenstva)
• Committee member: Neven Henigsberg (član povjerenstva)
• Committee member: Marina Šagud (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-03-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Cilj istraživanja bio je oblikovati statistički, multivarijabilni, prediktivni model najviših troškova formalne skrbi, liječenja i neformalne skrbi za bolesnike s dijagnosticiranom demencijom. Proveli smo prospektivno kohortno istraživanje u Domu zdravlja “Zagreb-Zapad”. Ciljana populacija bili su pacijenti u dobi od 60-80 godina s dijagnosticiranom demencijom koji žive u privatnim kućanstvima i njihovi neformalni njegovatelji. Uključili smo 240 bolesnika srednje dobi od 74 godine, a 186 (78%) bile su žene. Ukupni godišnji troškovi na razini populacije procijenjeni su na 594 milijuna eura, od čega oko 70% čine troškovi neformalne skrbi. Konačni prediktivni model uključivao je osam varijabli: dob, dob u vrijeme prve epizode demencije, broj kroničnih tjelesnih stanja u komorbiditetu, dijabetes i četiri čimbenika svakodnevnih životnih aktivnosti. Ukupna točnost u predviđanju gornjeg kvartila ukupnih troškova zdravstvene zaštite bila je 90%. Model je interno validiran nakon šest mjeseci. Točnost modela u validacijskom mjerenju bila je 83%. Temeljem provedenog istraživanja možemo zaključiti da je populacija osoba s demencijom heterogena i da postoje relativno velike razlike u troškovima koji im se pripisuju što daje novu perspektivu u adekvatnom planiranju terapijskih ciljeva i očekivanja.

Abstract (english)

The study aimed to create a statistical, multivariable, predictive model of the highest costs of formal care, treatment, and informal care for patients diagnosed with dementia. We conducted a prospective cohort study at the Health Center “Zagreb-Zapad”. The targeted population included patients aged 60–80 years, diagnosed with dementia, residing in private households, and their informal caregivers. We enrolled 240 patients with a median age of 74, and 186 (78%) were women. The total annual costs at the population level were estimated at 594 million EUR, with around 70% attributed to informal care costs. The final predictive model included eight variables: age, age at the time of the first episode of dementia, the number of comorbid chronic physical conditions, diabetes, and four factors related to activities of daily living. The overall accuracy in predicting the upper quartile of total healthcare costs was 90%. The model underwent internal validation after six months, and its accuracy in the validation measurement was 83%. We concluded that the population of people with dementia is heterogeneous, and there are relatively large differences in the costs attributed to them. This perspective provides new insights into adequately planning therapeutic goals and expectations.

• Keywords: Alzheimerova bolest; Demencija; Troškovi zdravstvene zaštite; Šećerna bolest
• Keywords (english): Alzheimer's disease; Dementia; Health Care Costs; Diabetes Mellitus
• Language: croatian
• URN:NBN: urn:nbn:hr:105:315295
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 103 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-04-18 08:20:18