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Cost of Dementia Care in Rural Thai Households

Objective: The purpose of the present paper was to quantify the cost associated with dementia care in rural Thailand.
Materials and Methods: A cross-sectional study was done on 140 dementia households with caregivers living in rural areas. The activity of daily living (ADL) and the instrumental activity of daily living (IADL), Resource Utilization in Dementia (RUD, Thai version) were used. The socioeconomic status of people with dementia, their families and their caregivers was collected. The hospital utilization data of people with dementia was obtained from the community and the sub-district health promoting hospitals. In terms of indirect costs, the replacement cost approach was employed.
Results: Most of the people with dementia were at low-income levels. The majority of dementia care cost was related to the non-medical care cost. The second highest cost was indirect costs or informal care cost, estimated as productivity loss of unpaid caregivers basing on replacement cost concept. The annual costs associated with dementia were estimated to be 90,644 Thai Baht (US$ 2,629) per person, of which 95% of the costs were associated with non-medical care and included 30% of indirect cost. Lastly, the dependency score was elastic to the total dementia care cost.
Conclusion: Informal care by family members, which normally was more common in low income family, was a major part of the time spent on caring for people with dementia, and accounted for 30% of the total cost of care. Policymakers should explore furthering the policy options of subsidizing rural households based on the dependency level.
Keywords: Cost of dementia care, Caregiving time, Dementia caregiver, Long-term care, Health services utilization