• Hans-Helmut König, Hanna Leicht, Christian Brettschneider, Cadja Bachmann, Horst Bickel, Angela Fuchs, Frank Jessen, Mirjam Köhler, Melanie Luppa, Edelgard Mösch, Michael Pentzek, Jochen Werle, Siegfried Weyerer, Birgitt Wiese, Martin Scherer, Wolfgang Maier, Steffi G Riedel-Heller, and AgeCoDe Study Group.
• Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: h.koenig@uke.de.
• J Am Med Dir Assoc. 2014 Feb 1;15(2):117-26.

ObjectiveTo compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective.DesignCross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort.SettingCommunity and nursing homes.ParticipantsOne hundred twenty-eight community-dwelling dementia patients and 48 dementia patients living in nursing homes.InterventionNone.MeasurementsUtilization and costs of medical care and long term care, including formal and informal social and nursing care based on proxy interviews. Informal care was valued using the replacement cost method.ResultsUnadjusted mean annual total costs including informal care were €29,930 ($43,997) for community-dwelling patients and €33,482 ($49,218) for patients living in nursing homes. However, multiple regression analysis controlling for age, sex, deficits in basic and instrumental activities of daily living and comorbidity showed that living in the community significantly increased total costs by €11,344 ($16,676; P < .01) compared with living in a nursing home, mainly due to higher costs of informal care (+€20,585; +$30,260; P < .001).ConclusionFrom the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for.Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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