# Cost of Psychiatric Inpatient Treatment for Dementia in Switzerland: A Case‐Level Analysis of Billing Data

## TL;DR

This study analyzed the cost of dementia treatment in Swiss psychiatric hospitals using billing data and found that costs were lower than previously estimated.

## Contribution

The study provides new case-level cost data for dementia treatment in Swiss hospitals under the TARPSY reimbursement system.

## Key findings

- The average total case cost for dementia treatment in 2019 was CHF 34,917 with an average stay of 39.7 days.
- Total case costs increased modestly from 2016 to 2019 and were lower than previous estimates.
- Cost homogeneity was satisfactory and did not improve significantly during the introduction of TARPSY.

## Abstract

The objective of this study was to investigate the cost of care for patients with a primary diagnosis of dementia in Swiss hospitals under the new TARPSY reimbursement system.

We used a dataset of the Swiss hospital reimbursement system TARPSY from 2016 to 2019, including all relevant remuneration variables at the patient level, to investigate hospital costs. Costs were analyzed by geographic location and hospital type. Homogeneity coefficients were used to analyze case cost homogeneity.

We identified 7090 cases in the TARPSY database who were treated in Swiss hospitals under the primary diagnosis of dementia from 2016 to 2019. Of these, 6747 cases were included in our analysis. The total case costs and daily costs increased from 2016 to 2019, whereas the length of stay decreased. The average total case cost in 2019 was CHF 34,917 (σ = 32,926), corresponding to a daily cost of CHF 946 (σ = 373.44). Patients were treated for an average of 39.7 (σ = 32.40) days. In 2019, the total costs billed according to TARPSY for 57,939 days of hospital care for dementia as the primary diagnosis were CHF 51.3 million. The case costs differed by region and hospital type. Overall, cost homogeneity for total case cost as a proxy for the quality of the cost calculation was “satisfactory, sufficient” and did not show a clear trend towards improvement during the introduction of TARPSY.

Our analysis provides reliable, case‐level cost data for dementia hospital treatment in Switzerland. The total cost of dementia treatment in psychiatric hospitals appears to be much lower than previous estimates had indicated. When correcting for changes in accounting practices, total case costs only increased modestly from 2016 to 2019.

We used case‐level cost data from the Swiss inpatient psychiatric reimbursement system TARPSY to calculate the cost of treatment for dementia as primary diagnosis.In 2019, the average total case for dementia as primary diagnosis was CHF 34,917 and the average length of stay of these patients was 39.7 days.Total case costs increased only modestly from 2016 to 2019 and appear to be much lower than indicated by previous analysis.

We used case‐level cost data from the Swiss inpatient psychiatric reimbursement system TARPSY to calculate the cost of treatment for dementia as primary diagnosis.

In 2019, the average total case for dementia as primary diagnosis was CHF 34,917 and the average length of stay of these patients was 39.7 days.

Total case costs increased only modestly from 2016 to 2019 and appear to be much lower than indicated by previous analysis.