The impact of the COVID-19 pandemic on institutionalization and healthcare costs in memory clinic patients

Background The COVID-19 pandemic disrupted healthcare services and daily routines, which may have particularly affected individuals with cognitive impairment or dementia who rely on continuity of care. However, the impact of these disruptions on institutionalization and healthcare costs remains largely unknown. Objective We investigated the impact of COVID-19-pandemic on institutionalization and healthcare costs in a mixed memory clinic population, compared to a well-balanced historical control group. Methods We included memory clinic patients from the Amsterdam Dementia Cohort: 1) n = 911 pandemic-patients (baseline: 2017–2018, follow-up: until 2021), and 2) n = 821 well-balanced historical controls (baseline: 2015–2016, follow-up: until 2019). Time to institutionalization was analyzed using restricted mean survival time (RMST), and healthcare costs using linear regression with spline knot at 2 years. Results We found no difference for time until institutionalization between groups for all diagnoses together. Stratified for syndrome diagnosis, we found that pandemic-patients with dementia (RMST between group contrast (BGC)[95%-CI] = −0.241 year[−0.456 – −0.026], i.e., −2.9 months) and another diagnosis (RMST BGC[95%-CI] = −0.214 year[−0.407 – −0.021], i.e., −2.6 months) had shorter time to institutionalization. Total healthcare costs did not differ between groups ( B [95%-CI] = 302.12 [−1229.17–1833.40], p = 0.699). Conclusions In conclusion, we found no indications of a significantly decreased or increased healthcare consumption as a result of COVID-19 pandemic.