Social Policy and Dementia: Costs and Pathways of Care

Project Outlines and Aims

Dementia needs to be managed effectively and efficiently. In doing so, health services need to define optimal pathways of care for the patients who present at their service, calculate the amount of staff involved at each stage, and consider the relative cost of treatment.

With regard to dementia, government reports have documented the amount of resources currently being used by Australians with dementia. These statistics reflect what is happening within the current system and do not tell us what it would cost to treat people using optimal treatment pathways. With the goal of modelling an optimal treatment pathway for dementia, our research group asked a group of dementia experts to describe what they believed were optimal pathways of treatment. Using national dementia prevalence data we then calculated the nationwide cost of having all Australians with dementia use these treatment pathways. At a glance, the cost of adopting the suggested treatment pathways does not appear to be a great deal more than what is currently being spent (although more comprehensive calculations and inclusions/exclusions need to be considered). The staff and service centres needed to accommodate the optimal treatment pathways however, may not exist at this time and staff shortages as well as future training programs will need to be considered.

This work is to be published as a chapter in a book “Tolkien II Team (in press). Tolkien II: A needs-based, costed stepped-care model for Mental Health Services. Sydney: World Health Organization Collaborating Centre for Classification in Mental health.” We hope the dementia pathways described in the chapter and the estimates of cost and staffing needs will initiate debate about optimal care and encourage services to consider how best to plan and run their own centres. At a national level, government planners may find the national estimates to be of some interest.

While the optimal treatment for dementia can be contrasted against what services are currently being used, less information exists about the services currently used by those with MCI. Our research group aims to rectify this gap. We are currently collecting data via the Memory and Ageing Study in which we ask people with MCI about the services they have used, their perceptions of the efficacy of those services, and any barriers they experienced in accessing assessment and treatment services. The service-use data may be used to estimate the current cost of managing MCI and the information about service perceptions and barriers to care may inform future treatment pathways of care.

Staff

Dr Tracy Anderson
Professor Gavin Andrews
Tolkien II Team
Memory and Ageing Study Investigators