Objectives: Despite increasing relevance, evidence about dementia in Austria is sparse, particularly in the context of the economic costs of dementia. The aim of the study is to contribute to the stream of research about costs of dementia. We demonstrate the magnitude of the burden of the disease affecting patients, caregivers, and the entire society.
Methods: The study uses the approach of population dementia-attributable fractions; intangible costs are discussed based on international literature. The estimation of health costs includes costs of dementia per se as well as dementia-attributable fractions of secondary diseases, calculated from relative risks from epidemiological studies. We transfer cost shares of the German disease-related cost accounts to Austrian health expenditures by age and sex. Dementia-attributable costs for residential, home, and live-in domestic care as well as for work loss of caregiving relatives are based on various data sources. The estimation of the costs of informal care, using a substitution approach, reflects total (not dementia-attributable) costs.
Results: The monetary costs of dementia for the year 2019 amount to a total of EUR 2.7 billion. About half of these costs are medical costs. Approximately 3.9 % of health care expenditures (excl. long-term care), 15.8 % of residential care expenditures and 22.5 % of home care expenditures were attributable to dementia in 2019. The production loss due to reduced working hours of caregiving relatives is estimated at EUR 31 million. In addition to monetary costs, total costs of informal care for dementia patients living at home account to EUR 4.9 billion including all supervision time or EUR 3.0 billion without supervision time.
Conclusions: Dementia is associated with high expenditures in the health and long-term care sector, which are set to increase further in coming years due to the aging of the population. The magnitude of national costs of informal care illustrates the substantial share of care work provided by relatives. Caregivers suffer from loss of free time, social isolation, depression, and poorer health in general, which are in turn risk factors for developing dementia themselves.
Owing to the lack of data, the results are partly based on estimates and assumptions. An improvement of the data situation would be highly necessary in order to adequately plan care supply and its costs for the future, especially in the face of increasing demand and an ageing workforce.