Cost effectiveness of non‐drug interventions that reduce nursing home admissions for people living with dementia

Abstract

AbstractINTRODUCTIONSix million Americans live with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD), a major health‐care cost driver. We evaluated the cost effectiveness of non‐pharmacologic interventions that reduce nursing home admissions for people living with AD/ADRD.METHODSWe used a person‐level microsimulation to model the hazard ratios (HR) on nursing home admission for four evidence‐based interventions compared to usual care: Maximizing Independence at Home (MIND), NYU Caregiver (NYU); Alzheimer's and Dementia Care (ADC); and Adult Day Service Plus (ADS Plus). We evaluated societal costs, quality‐adjusted life years and incremental cost‐effectiveness ratios.RESULTSAll four interventions cost less and are more effective (i.e., cost savings) than usual care from a societal perspective. Results did not materially change in 1‐way, 2‐way, structural, and probabilistic sensitivity analyses.CONCLUSIONDementia‐care interventions that reduce nursing home admissions save societal costs compared to usual care. Policies should incentivize providers and health systems to implement non‐pharmacologic interventions.