Jr. Economist intern
Economic Burden of Alzheimer’s Disease Dementia in Japan.
Published on: October 12, 2022
Original author: Ikeda, Shunya et al. (2021) (DOI: 10.3233/JAD-210075)
Alzheimer’s disease dementia (ADD) is the leading cause of long-term care in Japan. In Japan, the number of older adults aged 65 years or over, living with dementia was estimated to be 4,620,000 in 2012. In a projection using data from a dementia study in Hisayama town, the number of people living with dementia in 2025 and 2060 was estimated to be approximately 6.5 to 7 million and 8.5 to 11.5 million, respectively. This study estimates the annual healthcare and long-term care costs in the fiscal year 2018 for adults over 65 years of age with ADD in Japan and the informal care costs and productivity loss for their families. Methodology Costs for ADD-related medical treatment and long-term care were assessed based on the clinical dementia rating (CDR) score's evaluation of the disease's severity. Productivity loss for ADD family caregivers aged 20 to 69 years and informal care expenses for all ADD were calculated. To estimate the annual healthcare costs and long-term care costs for ADD, productivity loss, and informal care costs for the family caregivers of people living with ADD using MEDLINE, Ichushi-Web, the MHLW Grants system, and MHLW Statistical Surveys. Types of the cost included: (a) Healthcare costs (b) Public long-term care costs (c) Productivity loss (d) Informal care costs. Results & discussion The total healthcare cost of ADD was Japan YEN (JPY) 1,073 billion, of which 86% (JPY 923 billion) was attributed to healthcare costs other than ADD drug costs (JPY 151 billion). The healthcare costs other than ADD drug costs by severity were less than JPY 200 billion for CDR 0.5, CDR 1, and CDR 2, respectively, but increased to JPY 447 billion (48%) for CDR 3. The public long-term care costs were estimated to be JPY 4,783 billion, which increased according to the severity. Total productivity loss for ADD family caregivers aged 20–69 years was JPY 1,547 billion and the informal care cost for all ADD family caregivers was JPY 6,772 billion. Impact of research Japan may bear a heavier economic burden of ADD, which has a great impact on its national finances and ADD family caregivers. This study showed the difference in economic burden due to ADD severity and the burden was markedly heavy in more severely affected people living with ADD. In Japan’s rapidly aging society, the number of people living with ADD is expected to reach approximately 6.5 to 7 million by 2025 and 8.5 to 11.5 million by 2060 . To minimize the economic burden of ADD, prolonging healthy life expectancy is the key factor to be addressed. Efforts at the local government level in practice as well as at the private sector level will be important to realize the national dementia strategy of “living together” to create a respectful society for people with dementia, and prevention strategies to delay the onset or progression of the disease. Conclusion The findings have implications for the desired mix of public and private providers in India’s health system. A key structural cost driver was the inadequate regulation of for-profit companies. Cost-saving measures include strengthening public programs that deliver curative medical services close to communities.
Comparing the average cost of outpatient care of public and for-profit private providers in India.
Published on: August 12, 2022
Original author: Garg, S., Tripathi, N., Ranjan, A. et al. (2021) (DOI: 10.1186/s12913-021-06777-7)
In mixed healthcare systems like India's, it is crucial to understand the cost of care associated with various types of healthcare providers to influence policy discussions. Existing studies reporting Out of Pocket Expenditure (OOPE) per episode of outpatient care in public and private providers in India do not provide a fair comparison because they have not considered the government subsidies received by public facilities. In India, no public nor private health insurance covers outpatient treatment, therefore for-profit providers must cover all expenses from customer payments. Methodology The state of Chhattisgarh in India was taken as the area of study where the average direct cost per acute event was compared among public providers, for-profit formal providers, and informal private providers. The study used two datasets: a) Household survey on outpatient utilization and OOPE. b) Facility survey of public providers to find the input costs borne by the government per outpatient episode. Results & discussion The average cost per episode of outpatient care was – 1. Rs. 400 for public providers 2. Rs. 586 for informal private providers 3. Rs. 2643 for formal for-profit providers The disease profiles treated by various types of providers were consistent. In public facilities, the number of patients and personnel resources was the main cost factors. Nearby suppliers were less expensive than other options. Conclusion The findings have implications for the desired mix of public and private providers in India’s health system. A key structural cost driver was the inadequate regulation of for-profit companies. Cost-saving measures include strengthening public programs that deliver curative medical services close to communities.
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