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The economics of patient safety part III: long-term care: valuing safety for the long haul
- Authors:
- DE BIENASSIS Katherine, LLENA-NOZAL Ana, KLAZINGA Nicolaas S.
- Publisher:
- Organisation for Economic Co-operation and Development
- Publication year:
- 2020
- Pagination:
- 102
- Place of publication:
- Paris
Long-term care (LTC) institutions are now providing care to a greater number of people, and more residents with chronic conditions and multiple co-morbidities, than ever before. Trends suggest this strain will continue to increase as OECD populations continue to age. The total cost of avoidable admissions to hospitals from LTC facilities in 2016 was almost USD 18 Billion, equivalent to 2.5% of all spending on hospital inpatient care or 4.4% of all spending on LTC. Research shows that over half of the harm that occurs in LTC is preventable, and over 40% of admissions to hospitals from LTC are avoidable. The root causes of these events can be addressed through improved prevention and safety practices and workforce development – including skill-mix and education. Targeted investments in a number of key areas can have a significant impact by mitigating the main cost drivers of adverse events in LTC. (Edited publisher abstract)
The health and social care costs of a selection of health conditions and multi-morbidities
- Authors:
- BLAWAT Aleksandra, et al
- Publisher:
- Public Health England
- Publication year:
- 2020
- Pagination:
- 62
- Place of publication:
- London
An estimation of the health and social care costs of a selection of common health conditions and multi-morbidities. Specifically, the paper examines whether the impact of developing a condition on health and social care costs is greater for someone with no prior conditions, or for someone with an existing condition. This research project had two components: a literature review and an empirical estimation of the costs associated with MM. The literature review was used to inform and establish the methodology used in the empirical estimation. The empirical estimation used data on primary and secondary healthcare, prescriptions usage, social care data (for South Somerset) and estimates of probability of requiring social care, based on estimated health-related quality of life for patients with different conditions and combinations of conditions. The study found that the cost of treating an individual with a multimorbidity is not statistically different than the additive cost of treating 2 individuals, each with one of the conditions, controlling for age and costs unrelated to the condition. Similarly, applying the same methodology for social care costs (using South Somerset social care data) as for healthcare costs, the study did not find any evidence that multi-morbidity is associated with either an increase or a reduction in total individual cost compared to the sum of individual costs of patient, for social care costs. However, applying the alternative methodology for social care costs, which estimated social care need based on age and quality of life, the study estimated higher social care costs than those found by analysing the South Somerset data. This implies that social care need may be greater than local authority social costs in South Somerset. This may be due to the relative affluence of South Somerset, which would limit the proportion of patients eligible for local authority-funded social care. (Edited publisher abstract)
Evidence review: the impact of an ageing population on end of life care costs
- Author:
- TOWNSEND Matthew
- Publisher:
- London School of Economics and Political Science. Personal Social Services Research Unit
- Publication year:
- 2016
- Pagination:
- 20
- Place of publication:
- London
Summarises evidence on the likely impact that an ageing population will have on end of life care costs and how this could influence future health and social care costs within the UK. Key findings from the review include: population ageing is likely to increase acute care expenditures moderately, and more strongly increase expenditures in long-term and social care; multi-morbidity and dementia are highly associated with increased health expenditure at end of life, and that prioritising medical innovations that improve quality of life and functioning at end of life, and assisting individuals to remain living at home, have the greatest potential to lead to cost savings. Following the evidence review, three end of life interventions are described which have the potential to reduce health expenditures and some of the rising costs of an ageing population. These are palliative care teams, advance care planning, and care integration for individuals with multi-morbidity. It concludes that the cost of population ageing at end of life would be a greater concern if the health and social care system failed to adapt to the needs of an older and more complex patient cohort. (Edited publisher abstract)
Dementia and comorbidities: ensuring parity of care
- Authors:
- SCRUTTON Jonathan, BRANCATI Cesira Urzi
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2016
- Pagination:
- 48
- Place of publication:
- London
This report, supported by Pfizer, highlights the disparities in care and health outcomes that are associated with people living with dementia who also have comorbid illnesses. Informed by a systematic review of both academic and grey literature the report looks at how a diagnosis of dementia can affect the prevention, diagnosis, treatment and management of co-existing conditions. It also looks at the reasons for the differences in healthcare outcomes for people with dementia. The report finds that this lack of parity in care results in an increased risk of early mortality for people with dementia, increased costs of health care, and comorbid conditions only being detected once they become severe. It identifies six key areas which lead to the discrepancy in health outcomes for people with dementia and comorbidities: atypical symptoms, communication difficulties, a failure by the health system to recognise the individual as a whole, a knowledge gap of hospital staff and carers in caring for people with dementia and comorbidities, poor medical management, a lack of support to aid self-management and poor monitoring of comorbidities by health professionals. The final section of the report looks at how having dementia may affect the prevention, diagnosis, treatment and management of specific three conditions: depression, diabetes, and urinary tract infections. Illustrative ‘good’ care stories for each. It sets out seven recommendations to help ensure the parity of care for people with dementia and comorbidities. (Edited publisher abstract)
Can data solve the comorbidity puzzle?
- Authors:
- STREET Andrew, KASTERIDIS Panos, MARTIN Jeremy
- Journal article citation:
- Health Service Journal, 124(6394), 11 April 2014, pp.30-32.
- Publisher:
- Emap Healthcare
In South Somerset, the county council, district hospital, community provider and clinical commissioning group have set up the Symphony project to develop a model of integrated care to improve services and increase efficiency. It is designed to improve collaboration between different care settings. Part of the project involved building a large dataset comprising information about each individual in the population. The data found that for people who have a chronic condition, it is unusual for them to have only one condition. The project has found that is this multi-morbidity, not age, that drives the demand for health and social care. This article looks at the findings of the project to date and outlines some of the costs involved in caring for people according to care setting and condition. (Edited publisher abstract)
The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset’s Symphony Project
- Authors:
- KASTERIDIS Panos, et al
- Publisher:
- University of York. Centre for Health Economics
- Publication year:
- 2014
- Pagination:
- 60
- Place of publication:
- York
By analysing a large dataset, this report examines patterns of health and social care utilisation and costs for the local South Somerset population to identify which groups of people would most benefit from better integrated care. The study adopted four criteria to identify those groups who would most benefit from an integrated care approach, those with a high frequency of occurrence of underlying conditions; a high cost of care; utilisation of services across different settings; and a local consensus that changes to the pathway were feasible. The study looked at eight broad settings: primary care episodes and prescribing; acute inpatient and daycare; acute outpatient; mental health; community care; social care; and continuing care. The analysis identifies those groups which are the highest users of services by activity and cost. The report concludes that the more co-morbidities a person has, the more likely they are to require care across diverse settings, and the higher their costs. They would also most benefit form improved integrated care. Chaper 8 also provides analysis of costs for those with dementia.. (Edited publisher abstract)
Depression status, medical comorbidity and resource costs: evidence from an international study of major depression in primary care (LIDO)
- Authors:
- CHISHOLM Daniel, et al
- Journal article citation:
- British Journal of Psychiatry, 183(8), August 2003, pp.121-131.
- Publisher:
- Cambridge University Press
Despite the burden of depression, there remain few data on its economic consequences in an international context. The aim of this article is to explore the relationship between depression status (with and without medical comorbidity), work loss and health care costs, using cross-sectional data from a multi-national study of depression in primary care. Primary care attendees were screened for depression. Those meeting eligibility criteria were categorised according to DSM–IV criteria for major depressive disorder and comorbid status. Unit costs were attached to self-reported days absent from work and uptake of health care services. Medical comorbidity was associated with a 17–46% increase in health care costs in five of the six sites, but a clear positive association between costs and clinical depression status was identified in only one site. The economic consequences of depression are influenced to a greater (and considerable) extent by the presence of medical comorbidity than by symptom severity alone.