Table of Contents
Journal of Geriatrics
Volume 2014, Article ID 493793, 8 pages
Research Article

Institutionalization-Free Survival and Health Care Costs among Quebec Community-Dwelling Elderly Patients with Dementia

1Faculty of Pharmacy, Université de Montréal, CP 6128, succursale Centre-Ville, Montreal, QC, Canada H3C 3J7
2Department of Epidemiology & Biostatistics, McGill University, Montreal, QC, Canada H3A 1A1
3Department of Pharmacology, University of Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
4Research Center, University of Montreal Hospital Center (CRCHUM), Montreal, QC, Canada H2W 1T8

Received 12 July 2013; Revised 29 October 2013; Accepted 1 November 2013; Published 29 January 2014

Academic Editor: Shunichiro Shinagawa

Copyright © 2014 Sarah-Gabrielle Beland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Published data on burden of dementia mainly include patients of third-care facilities. Economic consequences in an outpatient setting remain poorly examined. Objectives. To evaluate institutionalization-free survival and direct health care costs of dementia in the Quebec community-dwelling elderly population. Methods. A retrospective cohort study was conducted using the Quebec administrative claims databases. The cohort included a random sample of patients with treated dementia between January 1, 2000, and December 31, 2009 (). The reference population included elderly patients without dementia matched in age group, gender, and index date. Using a third-party payer perspective, direct costs over 5 years were assessed. Results. Institutionalization-free survival at 5 years was lower in patients with dementia than in elderly without dementia (38.9% and 72.2%, resp.). Over 5 years, difference in mean total direct health care costs per patient was CAD$19,159, distributed into institutionalizations (CAD$13,598), hospitalizations (CAD$3,312), and prescribed medications (CAD$2,320). Costs of medical services were similar (−CAD$96). In the first year of followup, cost differentials were mainly attributable to hospitalizations, while in the last year (year 5) they were due to institutionalizations. Conclusion. This study confirms that dementia is an important socioeconomic burden in the community, the nature of which depends on disease progression.