- Title Information
- Title
- Applications of Decision Analysis in Alzheimer’s Research
- Type of Resource (primo)
- dissertations
- Name:
Personal
- Name Part
- Lopez Mendez, Mauricio
- Role
- Role Term:
Text
- creator
- Name:
Personal
- Name Part
- Trikalinos, Thomas A.
- Role
- Role Term:
Text
- Advisor
- Name:
Personal
- Name Part
- Jutkowitz, Eric
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Alarid-Escudero, Fernando
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Galarrga, Omar
- Role
- Role Term:
Text
- Reader
- Name:
Corporate
- Name Part
- Brown University. Department of Health Services, Policy and Practice
- Role
- Role Term:
Text
- sponsor
- Origin Information
- Copyright Date
- 2024
- Physical Description
- Extent
- 14, 144 p.
- digitalOrigin
- born digital
- Note:
thesis
- Thesis (Ph. D.)--Brown University, 2024
- Genre (aat)
- theses
- Abstract
- This dissertation addresses two critical issues in the decision analysis of non-pharmacologic interventions for dementia. The first issue is the incompatibility of existing decision-analytic frameworks with the dyadic nature of these interventions. Current frameworks, such as cost-utility and cost-effectiveness analyses, often focus on either the patient or the caregiver's perspective. This narrow focus can lead decision-makers to overlook the trade-offs and interdependencies between the preferences and health-related quality of life (HRQOL) of both the person living with dementia and their caregiver. Consequently, allocation decisions are often based on partial perspectives of the associated benefits and costs of interventions supporting both members of the dyads. To address this, a novel approach is proposed to model the collective preferences and utilities of dyads composed of people living with dementia and their family caregivers. This methodology is applied to measure dyadic time-trade-off weights using data from the Aging, Demographics, and Memory Study (ADAMS). The second issue pertains to evaluating transitional care interventions that help people with dementia age safely at home. I develop a discrete-event simulation (DES) model that represents the dynamics of transition between different care settings for a cohort of Medicare beneficiaries diagnosed with dementia. This includes transitions into and out of inpatient care, emergency care, institutionalized long-term care (nursing homes and skilled nursing facilities), and home- and community-based care. A set of interventions and composite strategies that increase the time people with dementia spend in the community is identified. A model-based cost-effectiveness analysis assesses the comparative and cost-effectiveness of these transitional-care interventions, considering competing transitions between different care settings and associated costs. The analysis uses nine years (2011-2020) of Medicare claims and nursing home minimum data set (MDS) assessments, which provide details on the place and time at which health services were provided, including stays in non-Medicare-paid nursing homes. A subset of potentially cost-effective interventions and strategies is identified, presenting an opportunity to adequately serve Medicare beneficiaries living with dementia without incurring prohibitive expenditures.
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00872518")
- Topic
- Computer simulation
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01014815")
- Topic
- Medicare
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00806532")
- Topic
- Alzheimer's disease
- Subject
- Topic
- Alzheimer's caregivers
- Subject
- Topic
- Alzheimer’s disease and related dementias
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00948375")
- Topic
- Group decision making
- Subject
- Topic
- health-related quality of life
- Subject
- Topic
- copula modeling
- Subject (fast)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/00880711")
- Topic
- Cost effectiveness--Mathematical models
- Subject
- Topic
- non-pharmacologic dementia interventions
- Language
- Language Term (ISO639-2B)
- English
- Record Information
- Record Content Source (marcorg)
- RPB
- Record Creation Date
(encoding="iso8601")
- 20241015