Integrated Dementia Care in the DementiaNet Program: Health Economic Reflections on Interpretation, Assessment, and Evaluation; Comment on “Effects of DementiaNet’s Community Care Network Approach on Admission Rates and Healthcare Costs: A Longitudinal Cohort Analysis”

Document Type : Commentary

Author

1 Hochschule Harz, Wernigerode, Germany

2 RWI – Leibniz Institute for Economic Research, Essen, Germany

Abstract

This commentary discusses the study by Remers et al. The authors analysed the impact of the Dutch DementiaNet programme on hospital admissions and healthcare costs for individuals with dementia. Using detailed claims data of over 38 000 insured individuals, the study found that participation in DementiaNet networks was associated with fewer hospital admissions and care days, as well as reduced hospital costs. Furthermore, participation in DementiaNet was linked to increased outpatient healthcare expenditure, while overall healthcare costs remained stable. This commentary seeks to place the findings within health economic theory. It posits that DementiaNet could reduce information asymmetries, transaction costs and disincentives in dementia care. Through its network- and primary care–based approach, DementiaNet plausibly improves care coordination, which might enable earlier interventions. This could account for the shift in costs from inpatient to outpatient care. Additionally, the commentary addresses methodological considerations, limitations, and directions for future research.

Keywords


  1. Remers TE, Kruse FM, van Dulmen SA, et al. Effects of DementiaNet’s community care network approach on admission rates and healthcare costs: a longitudinal cohort analysis. Int J Health Policy Manag. 2023;12:7700. doi:34172/ijhpm.2023.7700
  2. Nieuwboer MS, Richters A, van der Marck MA. Triple aim improvement for individuals, services, and society in dementia care: the DementiaNet collaborative care approach. Z Gerontol Geriatr. 2017;50(suppl 2):78-83. doi:1007/s00391-017-1213-3
  3. Richters A, Nieuwboer MS, Perry M, Rikkert MGO, Melis RJ, van der Marck MA. Evaluation of DementiaNet, a network-based primary care innovation for community-dwelling patients with dementia: protocol for a longitudinal mixed methods multiple case study. BMJ 2017;7(8):e016433. doi:10.1136/bmjopen-2017-016433
  4. Lee DCA, Tirlea L, Haines TP. Nonpharmacological interventions to prevent hospital or nursing home admissions among community-dwelling older people with dementia: a systematic review and meta-analysis. Health Soc Care Community. 2020;28(5):1408-1429. doi:1111/hsc.12965
  5. Reilly S, Miranda-Castillo C, Malouf R, et al. Case management approaches to home support for people with dementia. Cochrane Database Syst Rev. 2015;(1):CD008345. doi:1002/14651858.CD008345.pub2
  6. Chandra A, Coile C, Mommaerts C. What can economics say about Alzheimer’s disease? J Econ Lit. 2023;61(2):428-470. doi:1257/jel.20221426
  7. Arrow KJ. Uncertainty and the welfare economics of medical care. Am Econ Rev. 1963;53(5):941-973.
  8. Williamson OE. Transaction-cost economics: the governance of contractual relations. J Law Econ. 1979;22(2):233-261.
  9. McGuire T. Physician agency. In: Culyer AJ, Newhouse JP, eds. Handbook of Health Economics. Vol 1. Elsevier; 2000:461-536.
  10. Gibbons R, Roberts J, eds. The Handbook of Organizational Economics. Princeton University Press; 2013.
  11. Miller DL. An introductory guide to event study models. J Econ Perspect. 2023;37(2):203-230. doi:1257/jep.37.2.203
  12. Douven R, Burger M, Schut E. Grote prijsverschillen ziekenhuiszorg, ondanks concurrentie. Econ Stat Ber. 2018;103(4762):276-279.

Articles in Press, Corrected Proof
Available Online from 20 August 2025
  • Received Date: 02 July 2025
  • Revised Date: 18 August 2025
  • Accepted Date: 19 August 2025
  • First Published Date: 20 August 2025