Abstract
This doctoral thesis investigates one disease management program in
dementia located in Kalmar, Sweden with regard to the resource
utilization. Dementia is a devastating disease which mainly affects the
elderly. As the disease progresses the need for support increases.
Dementia is one of the most costly diseases in our society. Although our
understanding of dementia has advanced we have yet to discover a cure for
the disease. Nevertheless with our current knowledge we can accomplish a
great deal. The challenge is to incorporate this knowledge in order to
provide high quality care for the patients and the caregivers without
creating an economic burden for the society. It is therefore of interest
to evaluate this dementia management program which supports the patient
and caregiver from diagnosis to death.
In Study I, the dementia management program in Kalmar was assessed. The
program defined most of the expected new patients per year. And it was
introduced within the existing budget, after reallocation of resources
In Study II, examined costs of dementia diagnose assessment. Further was
the true cost per diagnosed patient. Identified for primary care and
specialist level. The study found that the cost of diagnosing dementia is
small compared to the total budget required to care for persons with
dementia, estimated to be approximately 1% of the total yearly cost of
dementia in Sweden.
In Study III, the use of selective psychotropic drugs in the elderly in
Kalmar was compared with Swedish national data. The study found that
after the introduction of the dementia management program, the use of
dementia drugs increased, and the use of neuroleptics decreased.
Furthermore the use of sedatives and drugs with anticholinergic effects
was lower in Kalmar as compared to the whole of Sweden.
In Study IV, examined resource utilization in dementia management in the
Kalmar municipality. The Älvsjö municipality and the whole of Sweden were
used for comparisons. The results suggest that the cost of dementia care
in the Kalmar municipality did not increase due to implementation of the
dementia program. Furtherer suggest the cost for dementia to be from
neutrally to lower for the municipality of Kalmar compare to the
municipality s in all of Sweden.
The results from this investigation of the dementia management program in
Kalmar, suggest that most of the new cases of dementia were diagnosed,
treated and followed up. The cost of the program fell within the existing
budget and no extra funding was required.
