Poster Presentations P2S432

P2-371 ETHNIC/CULTURAL

DIFFERENCES IN THE INCREMENTAL

COST OF HEALTH CARE SERVICES

ASSOCIATEDWITH

ALZHEIMER’S DISEASE

Jeffrey McCombs1, Karen Chu1, Lisa Mucha2, 1USC School of Pharmacy,

Los Angeles, California, United States; 2Pfizer Inc., Collegeville,

Pennsylvania, United States.

Background: Higher cost for nursing home care [LTC] is the primary factor

behind the incremental cost of Alzheimer’s Disease [AD]. The use of LTC ser-

vices to treat patients with AD may be sensitive to culture and ethnic mores

related to the care of elder family members. This study investigates if ethnic/

cultural differences exist in the incremental costs associatedwithAD.Methods:

Patients age 50+ were identified from de-identified Medicaid paid claims from

California [MediCal]. All patients were MediCal eligible for the period 2004-

2006 [survivors]. AD patients had at least one AD diagnosis. A 20% random

sample of non-AD patients was selected and amatched control group was iden-

tified using propensity score methods. Health care costs were summed over all

three years broken down by type of service. Multivariate statistical models were

estimated to document the incremental impact of AD on costs controlling for

baseline characteristics, including race. Interaction terms between race and

the AD indicator variable were used to measure racial difference in the impact

of AD on cost by type of service relative to whites. Results: The incremental

cost of AD in white patients was $52,827 over 3 years, primarily due to higher

costs of $37,258 for LTC, $5,147 for acute hospital serviceswith non-significant

increases in home health costs [$2,268] and medical costs [$7,782]. Black pa-

tients withAD consumed an additional $7,886 in LTC and $10,620 in total costs

relative towhite patientswithAD.HispanicADpatients accrued $25,666 less in

total cost than white AD patients, primarily due to lower LTC costs of $21,531.

Asian AD patients accrued $34,780 less in total costs and $20,962 less in LTC

costs than white AD patients. Over half of patients did not have data on race in

the Medi-Cal records. While AD patients with no race data also accrued lower

LTC costs thanwhite AD patients [-$33,859], they consumed significantlymore

home health care [+$22,972] and medical care [+$24,962] than white AD pa-

tients. Conclusions: Ethnicity has very significant impact on the total cost of

care provided to AD patients with Asian and Hispanic patients consuming

less LTC services.

P2-372 DESCRIPTIVE ANALYSIS OF

CAREGIVING NETWORK IN

DEMENTIA PATIENTS IN THE PROVINCE

OFALICANTE, SPAIN. WHO LOOKS

AFTER THE CAREGIVER?

Vicente Medrano Martinez1, Elena Toribio-Diaz2, Jose Molt�o-Jord�a3,

Isabel Beltran Blasco4, Irene Perez-Cerda5, 1Hospital Virgen de la Salud,

Elda (Alacant), Spain; 2Hospital del Henares, Coslada (Madrid), Spain;3Hospital Virgen de los Lirios, Alcoi (Alacant), Spain; 4Hospital Clinica

Benidorm, Benidorm, Spain; 5Hospital de Sant Vicent, Sant Vicent del

Raspeig, Spain.

Background: Women are usually the Principal Caregiver of demented pa-

tients, but changes in their socio-economic roles have modified the structure

of caregiving network for dementia patients. Aims: To analyze the profile of

the secondary caregiver (SC), formal caregiver (FC) and absent caregiver

(AC) involved in the care of these patients.Methods:Multicentric and pro-

spective study carried out in 4 hospitals in Alicante (June 2009/January

2010). Prospective inclusion of dementia patients caregivers. Variables an-

alyzed: 1. Secondary, Formal and Absent Caregivers demographic data

(age/ sex, civil and labour condition, studies, kinship). 2. SC roles: global

coordination of the patient, economical and/or sanitary tasks, transportation,

control treatment, domestic tasks, leisure/stimulation, daily activities. 3.

Nationality of the FC, private or institutional remuneration.4. Knowledge

in dementia. Results: 129 patients were included: 83.6% with 1 or 2 SC

(middle ages 50.9 6 15.1; 60.6% women; 80% married; 53.1% workers;

52% primary studies); 24.5% with FC (91.7% women, 45.5% married,

81.8% primary studies, 81.8% Spanish, 89% private remuneration); 35%

with some AC (73.9 % males, 80% married, 63% primary studies). Roles

developed by the SC: 17.9% global coordination, 18.5 % economical and/

or sanitary tasks, 45.2 % transportation, 33,1% treatment, 31.5 % domestic

tasks, 82.3 % leisure/stimulation, 37.1% daily activities. 13.6% of SC and

27.3 % of FC have any knowledge in dementia. Conclusions: Women are

the principal element in the caregiving network of the patient with dementia:

as support to the principal one or as FC (non-properly prepared for that task),

with male relatives (sons or sons-in law) the great absent. Better knowledge

of the caregiving network of dementia patients may help in their general

management.

P2-373 UTILIZATION OF DIRECT MEDICAL

CARE AND SUPPORT SERVICES OF

ALZHEIMER’S DISEASE PATIENTS

BY TYPE OF CAREGIVER

Lisa Mucha1, Johnathan Chapnick2, Jill Racketa1, Hillary Gross3, 1Pfizer

Inc., Collegeville, Pennsylvania, United States; 2Kantar Health, Princeton,

New Jersey, United States; 3Kanar Health, Princeton, New Jersey, United

States.

Background: Caregivers of Alzheimers Disease (AD) patients are charged

with obtaining care for their patient. The purpose of this study is to charac-

terize utilization of both direct and support services engaged by type of care-

giver: spouse, adult child or other type.Methods:Data were collected using

an internet-based survey, the Kantar Health Alzheimer’s Disease Caregivers

Study-Wave 17, administered in August 2009 to primary AD caregivers in

the US. Utilization of care was measured two ways: direct health care

(physician, ER and inpatient) and support services. Significance tests

were conducted using ANOVA for differences in continuous variables and

t-tests for categorical. The results are presented stratified by type of care-

giver: spouse, adult child or other. Results: Among 1,079 caregivers, there

were spouses (n ¼ 161), adult children (n ¼ 637) and others (n ¼ 281).

Those who were classified as “others” were mostly caring for a grandparent

(66%). Mean age for other and adult child caregivers (age 39 and 52 respec-

tively) was younger than spouses (66). There were few differences by care-

giver type regarding direct health care. Over 80% of all types reported

a physician visit for AD. Across all caregiver types, over 22% reported an

ER visit, and at least 16% said there was an AD inpatient admission. For

support services, family counseling was used by 19% spouses, 15% of adult

children, but 27% for others (p < 0.001). Food delivery services were used

by 9% of spouses, 15% for children and 24% of others (p < 0.001). Home

health aides were engaged by 19% of spouses, 26% of children and 35% of

others (p¼ 0.001); home nurses by 8% of spouses, 24% of children and 34%

of others (p < 0.001). Also, 11% of spouses, 14% of children and 22% of

others used public transportation for their patient (p¼ 0.002).Conclusions:

The utilization of direct health care for AD for the most part did not differ by

type of caregiver. However, thereweremarked differences for use of support

services, with spouses not engaging these services as much as adult children

or other caregivers. Organizations providing support services may want to

target efforts to specific types of caregivers.

P2-374 THE DIFFERENCES OF CAREGIVER’S

QUALITY OF LIFE BASED ON DEGREE OF

SEVERITY OF PATIENT DEMENTIA

Martina Wiiwie Nasrun, University of Indonesia, Jakarta, Indonesia.

Background: Being cared of geriatric patients with dementia was not an

easy to do, in this occasion we need knowledge, skill, intention, loyalty

and passionate. Caregivers can occur anxiety, upset, anger, or feel exhausted