The costs and benefits of an integrated approach to dementia

BACKGROUND: An integrated approach to dementia is generally recommended because no one discipline is adequately equipped it deal with the complex psychic, physical and social problems that are inherent in dementia. A multidisciplinary approach, however, leads inevitably to higher costs. It is not known what the cost/benefit ratio will be. AIM: To describe our research into the costs and benefits of an integrated approach to dementia involving the use of a diagnostic research centre for psycho-geriatrics (DRC-PG) and thereafter to compare our findings with the results of other studies of the costs and benefits of an integrated approach. METHOD: We performed a prospective and randomised efficiency study and we compared our findings with the results of other studies of the costs and benefits of an integrated approach. We reviewed recent literature. RESULTS: The DRC-PG was more effective than normal care as far as the patients' quality of life was concerned, but was not more expensive. It can therefore be regarded as a cost-effective facility for ambulatory patients with dementia. Three other studies provided additional empirical evidence of the success of a similar integrated approach in various sectors involved in the care of patients with dementia. CONCLUSION: An integrated approach with regard to the diagnosis, treatment and management of dementia produces favourable results. More research is needed into the efficacy and cost-effectiveness of integrated care programmes. This should result in improvements in the care and treatment of patients with dementia.

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