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Abstract：
Alzheimer\'s disease (AD) is an important geriatric disease that creates challenges in health policy planning. There is no previous attempt to quantify the actual direct healthcare cost of AD among older adults in Malaysia. This retrospective observational study with bottom-up micro-costing approach aimed to evaluate the direct healthcare expenditure on AD along with its potential predictors from healthcare providers\' perspective, conducted across six tertiary hospitals in Malaysia. AD patients aged 65 and above who received AD treatment between 1 January 2016 and 31 December 2021 were included. Direct healthcare cost (DHC) of AD was estimated by extracting one-year follow-up information from patient medical records. As a result, 333 AD patients were included in the study. The mean DHC of AD was estimated RM2641.30 (USD 572.45) per patient per year (PPPY) from the healthcare payer\'s perspective. Laboratory investigations accounted for 37.2% of total DHC, followed by clinic care (31.5%) and prescription medicine (24.9%). As disease severity increases, annual DHC increases from RM2459.04 (mild), RM 2642.27 (moderate), to RM3087.61 (severe) PPPY. Patients aged 81 and above recorded significantly higher annual DHC (p = 0.003). Such real-world estimates are important in assisting the process of formulating healthcare policies in geriatric care.
摘要：
阿尔茨海默病(Alzheimer’sdisease,AD)是一种重要的老年病,给卫生政策规划带来了挑战。以前没有尝试量化马来西亚老年人AD的实际直接医疗费用。这项采用自下而上微观成本核算方法的回顾性观察研究旨在评估AD的直接医疗保健支出及其从医疗保健提供者角度的潜在预测因素。在马来西亚的六家三级医院进行。纳入2016年1月1日至2021年12月31日期间接受AD治疗的65岁及以上AD患者。通过从患者病历中提取一年的随访信息来估计AD的直接医疗保健成本（DHC）。因此,333名AD患者纳入研究。从医疗保健支付者的角度来看，AD的平均DHC估计为每位患者每年RM2641.30（572.45美元）（PPPY）。实验室调查占总DHC的37.2%，其次是临床护理(31.5%)和处方药(24.9%)。随着疾病严重程度的增加，年度DHC从RM2459.04（轻度）增加，2642.27令吉(中等),至RM3087.61（严重）PPPY。81岁及以上的患者记录的年度DHC明显较高（p=0.003）。这种现实世界的估计对于协助制定老年保健保健政策的过程非常重要。
