Dementia Care Mapping and Patient-Centred Care in Australian residential homes: An economic evaluation of the CARE Study, CHERE Working Paper 2008/4



Table 4: Incremental Costs and Benefits

CMAI
change
over
intervention
(at follow-
up)

Average
number
of
residents
per site

Total
CMAI
point
reduction
for site (at
follow-
up) vs.
UC

Incremental
cost of
intervention
(vs. UC)

Cost per
behaviour
averted vs.
UC
(follow-up)

Cost per
behaviour
averted vs.

PCC
(follow-up)

UC

+8.4(+7.4)

Î6A

NA

NA

NA

N/A

PCC

-5.8(-10.3)

19.8-

281(350)

2,250

$8.01

($6.43)

N/A

DCM

-1.0(-2.4)

21.8

205(214)

10,034

$48.95

($46.89)

-$102.42 (-

$57.24)

N/A = not applicable

The results indicate that the DCM intervention is subject to what is referred to in the
economic evaluation literature as “dominance”. That is, relative to PCC, it averts
fewer negative behaviours and is more costly. This remains the case whether the post-
intervention or follow-up CMAI scores are used. A less effective and more costly
intervention is not recommended on efficiency grounds. Therefore, DCM is excluded
from the incremental component of the economic evaluation. The cost per negative
behaviour averted in the PCC group relative to UC was $8.01 (post-intervention) and
$6.43 (at follow-up).

This result remained robust under sensitivity analysis. Under all ranges of model
values, DCM remained subject to dominance. The cost per behaviour averted for the
PCC group relative to UC ranged from $6.23 to $9.79 post-intervention, and from
$5.00 to $7.86 at follow-up, suggesting that different organisational contexts will
produce different results. However, the differences in the ICER do not suggest DCM
to be the cost-effective option under any of the circumstances considered here.



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