Assessing technologies in dementia care
A conceptual health-economic model
Jinjing Fu (University Medical Center Groningen)
Ron Handels (Maastricht University, Karolinska Institutet)
Matthieu Arendse
Teis Arets (Eindhoven University of Technology)
Ellis Bartholomeus (Eindhoven University of Technology)
Marco Blom (Alzheimer Center Amsterdam)
Sascha Bolt (Tilburg School of Social and Behavioral Sciences)
Wijnand Ijsselsteijn (Eindhoven University of Technology)
Paul Raingeard de la Blétière (TU Delft - Electrical Engineering, Mathematics and Computer Science)
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Abstract
Background: Technologies such as assistive devices and social robots show promise in supporting people with dementia and their caregivers. However, their long-term cost-effectiveness remains unclear, and existing health-economic models are limited in capturing the relevant outcomes. Objective: This study aims to conceptualize a health-economic model to assess the potential impact of care technologies in dementia care on lifetime quality of life and care use. Methods: We summarized an impact pathway of three care technologies and conceptualized a health-economic model to estimate the long-term impact on quality of life and care use, drawing on literature and multidisciplinary expert input. Results: We conceptualized a cohort-based Markov state-transition model simulating states of dementia severity progression (mild, moderate, severe), care setting transitions (no formal care, home care, nursing home), and mortality. Intervention effects are modeled through surrogate outcomes such as functional status and caregiver burden associated to care transitions and quality of life. Conclusions: This model offers a framework for early health technology assessment of assistive technologies in dementia, supporting extrapolation of effects beyond limited trial data. Future work should focus on developing and operationalizing this model, applying it to establish the value of dementia care technologies.
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