Cost of diagnosing dementia in a German memory clinic

Bernhard Michalowsky, Steffen Flessa, Johannes Hertel, Olav Goetz, Wolfgang Hoffmann, Stefan Teipel, Ingo Kilimann

Little is known about diagnostic work-ups or the costs of diagnosing dementia in specialized care. Here, we analyzed the costs of diagnosing dementia according to specific dementia disorders. A prospective descriptive design was used to analyze the cost of diagnosing dementia for 120 patients with suspected dementia at a German memory clinic. The duration of clinical consultations and use of technical procedures were recorded by the memory clinic staff. To detect cost drivers, a multiple linear regression model was used. Of patients with suspected dementia, 44% were diagnosed with dementia. The total cost per patient and diagnostic process amounted to 501 € across all patients and 659 € for patients who were diagnosed with dementia. The costs varied between 649 € for patients with Alzheimer's disease, 662 € for patients with vascular or mixed dementia, and 705 € for patients with unspecific dementia. A final diagnosis of dementia was the only factor that was significantly associated with the diagnostic cost (b = 356, CI(-) 182, CI(+) 531, p = 0.001). The high range of costs reflects differences in diagnostic demands depending on the etiology of dementia. This variation needs to be transferred into reimbursement. Further studies are needed to assess the influence of the type of cognitive impairment and of the setting on diagnostic costs.