Assessing the Relationship between Health Utilities, Quality of Life, and Health Care Costs in Alzheimer's Disease: The CATIE-AD Study

作者：Miller E A^*; Rosenheck R A; Schneider L S

来源：Current Alzheimer Research, 2010, 7(4): 348-357.

DOI：10.2174/156720510791162386

• Alzheimer's disease
• costs
• health utilities index
• quality of life
• correlates

Objectives: To examine the relationship between multiple measures of health care costs and health utilities, quality of life, and other factors in Alzheimer's Disease (AD).
Research Design: Data were obtained via caregiver proxy at baseline and 3-6- and 9-months following study entry on 421 patients with AD who participated in the CATIE-AD trial of antipsychotic medication. Spearman rank correlations and mixed models (using logged costs) were used to examine the correlates of health care costs.
Measures: Health care costs include inpatient hospital, nursing home, residential care, combined institutional, outpatient, ancillary drug, and total costs. Correlates include the AD-Related Quality of Life Scale (ADRQoL) and Health Utilities Index (HUI)-III.
Results: Total monthly health care costs averaged $1,205 during the study period. Each.10 increment on the HUI-III (stronger health utilities) was associated with a decrease in institutional, outpatient, and total costs of 9.7%, 6.9%, and 8.2%, respectively. Each one-point increase on the ADRQoL (better quality of life) was associated with an increase in ancillary drug and total costs of 1.7% and 2.1%. Total costs tended to be lower for female patients (beta=-.325) with better physical functioning (beta=-.017) but higher for less cognitively impaired individuals (beta=.038). Older (beta=.025), non-Hispanic Whites (beta=.575) tended have higher outpatient costs, those with better physical functioning lower institutional costs (beta=-.019). Drug costs tended to be lower for females (beta=-.427) and higher for those with greater psychiatric symptoms (beta=.016).
Conclusion: The HUI-III findings suggest that health utilities could be combined with other known correlates of costs to inform resource allocation cost-effectiveness analyses associated with AD. The ADRQoL findings suggest that better quality of life may make it easier for caregivers to identify problems and/or to access and maintain certain types of health system contacts.

• 出版日期2010-6