Differences in Function and Healthcare Cost of Older Adults with Dementia by Long-Term Care Service Type: A National Dataset Analysis

Abstract

This study aims to analyze the function and cost changes among long-term care insurance (LTCI) beneficiaries with low-severity dementia according to their LTCI service type. Data were collected from the Korean LTCI and national health insurance (NHI) datasets. Participants were 4414 beneficiaries with dementia aged 65 or older who received LTC services continuously for 4 years (2008–2011). LTCI service types were classified into home care (HC), institutional care (IC), and combined care (CC). Activities of daily living (ADL), cognitive function, medical cost, and benefit-cost were assessed. Linear mixed models and multiple regression models were used to analyze the changes in function and costs of the beneficiaries. ADL, cognitive function, medical cost, and benefit-cost differed significantly depending on the service type and time (p < 0.001). LTCI service types affected the degree of changes in ADL, cognitive function, medical cost, and benefit-cost over four years and showed negative changes in IC and CC beneficiaries than HC beneficiaries. HC is a cost-effective way to maintain the function of beneficiaries with low-severity dementia. Thus, efforts are needed to actively promote HC services.

The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence

“…LTC use in the previous year was associated with a decrease in inpatient costs but an increase in outpatient costs, although neither effect was statistically significant. Since other studies reported a positive association between LTC use and acute medical use, as well as between LTC costs and medical costs [39][40][41], the relationship between LTC utilization and medical spending needs further investigation. In addition, further studies are required of specific older patient groups with chronic conditions other than UI (e.g., dementia, frailty, or polypharmacy) [42,43].…”