The main objective is to examine the cost impacts of interventions designed to enhance family caregiving for Alzheimer's Disease. The interventions are part of the NIH-supported REACH (Resources for Enhancing Alzheimer's Caregiver Health) project. The research will extend the REACH analysis of outcomes to look at cost impacts across interventions. The study will use measures of healthcare utilization, caregiving costs and outcomes being collected for the core REACH data set.
The Specific Aims are to: 1. Measure the cost of community-based caregiving for Alzheimer disease across ethnically and geographically diverse populations; and 2. Calculate and compare the cost-effectiveness rations for the two interventions with technology components. The study will also include these analyses: 1. Analysis of the offset effect: whether the interventions that reduce caregiver stress also have an impact on health services utilization; and 2. A comparison of the sensitivity of cost estimates to two different approaches for imputing informal caregiving costs. This five-year study is a significant advance over earlier work because of the following: there is little available data on the impact of caregiver interventions on caregiver health services utilization; studies that have estimated caregiving cost have been limited in terms of the geographic and ethnic homogeneity of their samples; and previous estimates of caregiving cost have not compared the market value and opportunity cost approaches to cost imputation. In addition, the cost effectiveness analysis of two intervention sites with technology components will allow us to examine the potential of non-labor intensive interventions to either contribute to more traditional behavioral interventions or stand alone in the support of caregivers.
