Tong, T., Thokala, P. orcid.org/0000-0003-4122-2366, McMillan, B. et al. (2 more authors) (2017) Cost effectiveness of using cognitive screening tests for detecting dementia and mild cognitive impairment in primary care. International Journal of Geriatric Psychiatry , 32 (12). pp. 1392-1400. ISSN 0885-6230
Abstract
INTRODUCTION: We estimated the cost effectiveness of different cognitive screening tests for use by General Practitioners (GPs) to detect cognitive impairment in England. METHODS: A patient-level cost-effectiveness model was developed using a simulated cohort that represents the elderly population in England (65 years and older). Each patient was followed over a lifetime period. Data from published sources were used to populate the model. The costs include government funded health and social care, private social care and informal care. Patient health benefit was measured and valued in Quality Adjusted Life Years (QALYs). RESULTS: Base-case analyses found that adopting any of the three cognitive tests (Mini-Mental State Examination, 6-Item Cognitive Impairment Test or GPCOG (General Practitioner Assessment of Cognition)) delivered more QALYs for patients over their lifetime and made savings across sectors including healthcare, social care and informal care compared with GP unassisted judgement. The benefits were due to early access to medications. Among the three cognitive tests, adopting the GPCOG was considered the most cost-effective option with the highest Incremental Net Benefit (INB) at the threshold of £30 000 per QALY from both the National Health Service and Personal Social Service (NHS PSS) perspective (£195 034 per 1000 patients) and the broader perspective that includes private social care and informal care (£196 251 per 1000 patients). Uncertainty was assessed in both deterministic and probabilistic sensitivity analyses. CONCLUSIONS: Our analyses indicate that the use of any of the three cognitive tests could be considered a cost-effective strategy compared with GP unassisted judgement. The most cost-effective option in the base-case was the GPCOG. Copyright © 2016 John Wiley & Sons, Ltd.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 John Wiley & Sons, Ltd. This is an author produced version of a paper subsequently published in International Journal of Geriatric Psychiatry. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | 6CIT; GPCOG; MMSE; cognitive screening tests; cost effectiveness analysis; decision model; dementia; early diagnosis dementia; primary care |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Funding Information: | Funder Grant number DEPARTMENT OF HEALTH UNSPECIFIED |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 01 Dec 2016 13:45 |
Last Modified: | 29 Jan 2018 11:37 |
Published Version: | https://doi.org/10.1002/gps.4626 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/gps.4626 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:108822 |