15 research outputs found
An Analysis of the Public Financial Support Eligibility Rule for French Dependent Elders with Alzheimerās Disease
AbstractBackgroundIt is crucial to define health policies that target patients with the highest needs. In France, public financial support is provided to dependent patients: it can be used to finance informal care time and nonmedical care use. Eligibility for public subsidies and reimbursement of costs is associated with a specific tool: the autonomie gĆ©rontologie groupes iso-ressources (AGGIR) scale score.ObjectiveOur objective was to explore whether patients with Alzheimerās disease who are eligible for public financial support have greater needs than do noneligible patients.MethodsUsing data from the DĆ©pendance des patients atteints de la maladie dāAlzheimer en France study, we calculated nonmedical care expenditures (in ā¬) using microcosting methods and informal care time demand (hours/month) using the Resource Use in Dementia questionnaire. We measured the burden associated with informal care provision with Zarit Burden Interview. We used a modified two-part model to explore the correlation between public financial support eligibility and these three variables.ResultsWe find evidence of higher informal care use, higher informal caregiversā burden, and higher care expenditures when patients have an AGGIR scale score corresponding to public financial support eligibility.ConclusionsThe AGGIR scale is useful to target patients with the highest costs and needs. Given our results, public subsidies could be used to further sustain informal caregivers networks by financing programs dedicated to lowering informal caregiversā burden
Reliability, Validity, and Interpretation of the Dependence Scale in Mild to Moderately Severe Alzheimer's Disease
INTRODUCTION: The Dependence Scale (DS) was designed to measure dependence on others among patients with Alzheimer's disease (AD). The objectives of this research were primarily to strengthen the psychometric evidence for the use of the DS in AD studies. METHODS: Patients with mild to moderately severe AD were examined in 3 study databases. Within each data set, internal consistency, validity, and responsiveness were examined, and structural equation models were fit. RESULTS: The DS has strong psychometric properties. The DS scores differed significantly across known groups and demonstrated moderate to strong correlations with measures hypothesized to be related to dependence (|r| >/= .31). Structural equation modeling supported the validity of the DS concept. An anchor-based DS responder definition to interpret a treatment benefit over time was identified. DISCUSSION: The DS is a reliable, valid, and interpretable measure of dependence associated with AD and is shown to be related to--but provides information distinct from--cognition, functioning, and behavior
Informal Care Time and Cost in a Large Clinical Trial Sample of Patients with Mild to Moderate Alzheimerās Disease: Determinants and Level of Change Observed
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Impact of Zanamivir Treatment on Productivity, Health Status and Healthcare Resource Use in Patients with Influenza
Objective: This study examined the impact of zanamivir treatment on patient morbidity in patients with influenza. Design and setting: This was a multicentre, randomised, double-blind, parallel-group study conducted in 14 countries in Europe and North America during the winter of 1995/1996. Patients and participants: The study included 722 individuals with virologically confirmed influenza. Interventions: Two different zanamivir treatment regimens [twice daily (bid) or 4 times daily (qid) for 5 days] were compared with placebo. Main outcome measures and results: Efficacy was measured using a number of patient-assessment questionnaires. Results showed that significantly fewer patients with influenza who were treated with zanamivir had additional contacts with healthcare professionals compared with those who received placebo (8 vs 14%; pCost of illness, Influenza virus infections, Pharmacoeconomics, Resource use, Zanamivir
Impact of Zanamivir Treatment on Productivity, Health Status and Healthcare Resource Use in Patients with Influenza
Dependence in Alzheimer's disease and service use costs, quality of life, and caregiver burden: the DADE study
BACKGROUND:
Most models determining how patient and caregiver characteristics and costs change with Alzheimer's disease (AD) progression focus on one aspect, for example, cognition. AD is inadequately defined by a single domain; tracking progression by focusing on a single aspect may mean other important aspects are insufficiently addressed. Dependence has been proposed as a better marker for following disease progression.
METHODS:
This was a cross-sectional observational study (18 UK sites). Two hundred forty-nine community or institutionalized patients, with possible/probable AD, Mini-Mental State Examination (3-26), and a knowledgeable informant participated.
RESULTS:
Significant associations noted between dependence (Dependence Scale [DS]) and clinical measures of severity (cognition, function, and behavior). Bivariate and multivariate models demonstrated significant associations between DS and service use cost, patient quality of life, and caregiver perceived burden.
CONCLUSION:
The construct of dependence may help to translate the combined impact of changes in cognition, function, and behavior into a more readily interpretable form. The DS is useful for assessing patients with AD in clinical trials/research