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Steinbeisser, K. ; Schwarzkopf, L. ; Graessel, E.* ; Seidl, H.

Cost-effectiveness of a non-pharmacological treatment vs. “care as usual” in day care centers for community-dwelling older people with cognitive impairment: Results from the German randomized controlled DeTaMAKS-trial.

Eur. J. Health Econ. 21, 825–844 (2020)
Postprint DOI PMC
Open Access Green
Background: Cognitive impairment in older adults causes a high economic and societal burden. This study assesses the cost-effectiveness of the multicomponent, non-pharmacological MAKS treatment vs. “care as usual” in German day care centers (DCCs) for community-dwelling people with mild cognitive impairment (MCI) or mild to moderate dementia over 6 months. Methods: The analysis was conducted from the societal perspective alongside the cluster-randomized controlled, multicenter, prospective DeTaMAKS-trial with waitlist group design. Outcomes were Mini-Mental Status Examination (MMSE) and Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM) of 433 individuals in 32 DCCs. Incremental differences in MMSE and ETAM were calculated via a Gaussian-distributed and incremental cost difference via a Gamma-distributed Generalized Linear Model. Cost-effectiveness was assessed via cost-effectiveness planes and cost-effectiveness acceptability curves (CEAC). Results: At 6 months, MMSE (adjusted mean difference = 0.92; 95% confidence interval (CI): 0.17 to 1.67; p = 0.02) and ETAM (adjusted mean difference = 1.00; CI: 0.14 to 1.85; p = 0.02) were significantly better in the intervention group. The adjusted cost difference was − €938.50 (CI: − 2733.65 to 763.13; p = 0.31). Given the CEAC, MAKS was cost-effective for 78.0% of MMSE and 77.4% for ETAM without a need for additional costs to payers. Conclusions: MAKS is a cost-effective treatment to stabilize the ability to perform activities of daily living and cognitive abilities of people with MCI or mild to moderate dementia in German DCCs. Thus, MAKS should be implemented in DCCs.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Cost-effectiveness Analysis ; Dementia ; Etam ; Mci ; Mmse ; Non-pharmacological Treatment
ISSN (print) / ISBN 1618-7598
e-ISSN 1618-7601
Zeitschrift The European journal of health economics
Quellenangaben Band: 21, Heft: , Seiten: 825–844 Artikelnummer: , Supplement: ,
Verlag Springer
Verlagsort Berlin ; Heidelberg
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Health Economics and Health Care Management (IGM)