Search results for ‘Subject term:"intermediate care"’ Sort:
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Costs and health outcomes of intermediate care: results from five UK case study sites
- Authors:
- KAAMBWA Billingsley, et al
- Journal article citation:
- Health and Social Care in the Community, 16(6), December 2008, pp.573-581.
- Publisher:
- Wiley
The objectives of this study were to explore the costs and outcomes associated with different types of intermediate care (IC) services, and also to examine the characteristics of patients receiving such services. Five UK case studies of 'whole systems' of IC were used, with data collected on a sample of consecutive IC episodes between January 2003 and January 2004. Statistical differences in costs and outcomes associated with different IC services and patient groups were explored. Factors associated with variation in IC episode outcomes were explored using an econometric framework. Data were available for 2253 episodes of IC. In terms of Department of Health criteria, a large proportion of patients (up to 47% of those for whom data were available) in this study were inappropriately admitted to IC services. As regards service function, compared to supported discharge, admission avoidance services were associated with both lower costs and greater health and functional gains. These gains appear to be driven, in part, by illness severity (more dependent patients tended to gain most benefit). In addition, these gains appear to be larger where the admission was appropriate. This study suggests a need for the development and application of robust and reliable clinical criteria for admission to IC, and close co-operation between hospital and community service providers over selection of patients and targeting of IC and acute care services to meet defined clinical need.
A national evaluation of the costs and outcomes of intermediate care for older people
- Authors:
- BARTON Pelham, et al
- Publisher:
- University of Leicester. Leicester Nuffield Research Unit
- Publication year:
- 2006
- Pagination:
- 167p., bibliog.
- Place of publication:
- Leicester
A national evaluation of the costs and outcomes of intermediate care for older people. Intermediate care is a key government priority, with £900 million announced in the NHS Plan. This three year evaluation from the Universities of Birmingham, Leicester and Sheffield focuses on the factors that help and hinder the development of intermediate care, on progress to date, and on the costs and outcomes associated with different types of intermediate care. The evaluation, which was funded from the Policy Research Programme and the MRC, seeks to establish the range, spread and speed of development of intermediate care services nationally, and to explore commissioners’, practitioners’ and service users’ views and experiences of intermediate care. HSMC’s contribution to the evaluation has centred upon two main areas: Colleagues within the Health Economics Facility (HEF) have explored the costs of intermediate care schemes in relation to their outcomes and synthesised evidence on the costs and outcomes of different models of intermediate care and on best practice; HSMC colleagues have carried out research in several case-study sites in order to explore the development of intermediate care in depth, including those factors which facilitate and constrain progress.
The impact of workforce flexibility on the costs and outcomes of older people's services: a policy and literature review
- Authors:
- NANCARROW Susan, et al
- Publisher:
- University of Sheffield. School of Health and Related Research (ScHARR)
- Publication year:
- 2006
- Pagination:
- 120p.
- Place of publication:
- Sheffield
Examines how, and with what impact, workforce substitution and specialisation is influenced by workforce change policies in the context of older peoples’ community and intermediate care services.
A national evaluation of the costs and outcomes of intermediate care for older people: executive summary
- Authors:
- BARTON Pelham, et al
- Publisher:
- University of Birmingham. Health Services Management Centre
- Publication year:
- 2006
- Pagination:
- 10p.
- Place of publication:
- Birmingham
Intermediate care is a key government priority, with £900 million announced in the NHS Plan. This three year evaluation from the Universities of Birmingham, Leicester and Sheffield focuses on the factors that help and hinder the development of intermediate care, on progress to date, and on the costs and outcomes associated with different types of intermediate care. The evaluation, which was funded from the Policy Research Programme and the MRC, seeks to establish the range, spread and speed of development of intermediate care services nationally, and to explore commissioners’, practitioners’ and service users’ views and experiences of intermediate care.
Short stay intermediate care services in a range of housing and care settings
- Author:
- PETER FLETCHER ASSOCIATES
- Publisher:
- DH Care Networks. Housing Learning and Improvement Network
- Publication year:
- 2009
- Pagination:
- 13p.
- Place of publication:
- London
This Factsheet considers how intermediate care within extra care housing works for commissioners, providers and service users. It updates previous factsheets following the Department of Health’s guidance on Intermediate Care issued as part of the ‘Prevention Package’ earlier in 2009. In undertaking the background research for the case study, a questionnaire was sent to organisations that had received funding from the Department of Health Extra Care Housing fund, where it appeared that there was an intermediate care element included in the funding bid. In addition to the focus on extra care, the Factsheet also considers the provision of intermediate care within other settings including sheltered housing and purpose built provision. The focus is on practical working models within different settings. There has not yet been any national evaluation of the costs and outcomes of intermediate care in extra care housing. However, the Department of Health and the Medical Research Council commissioned a national evaluation of the costs and outcomes of Intermediate Care services for older people from the Nuffield Community Care Studies Unit (NCCSU), University of Leicester, and the Health Service Management Centre (HSMC), University of Birmingham.
Reablement services for people at risk of needing social care: the MoRe mixed-methods evaluation
- Authors:
- BERESFORD Bryony, et al
- Journal article citation:
- Health and Social Care Delivery Research, 7(16), 2019, Online only
- Publisher:
- National Institute for Health Research
- Place of publication:
- London
BACKGROUND: Reablement is an intensive, time-limited intervention for people at risk of needing social care or an increased intensity of care. Differing from home care, it seeks to restore functioning and self-care skills. In England, it is a core element of intermediate care. The existing evidence base is limited. OBJECTIVES: To describe reablement services in England and develop a service model typology; to conduct a mixed-methods comparative evaluation of service models investigating outcomes, factors that have an impact on outcomes, costs and cost-effectiveness, and user and practitioner experiences; and to investigate specialist reablement services/practices for people with dementia. METHODS: Work package (WP) 1, which took place in 2015, surveyed reablement services in England. Data were collected on organisational characteristics, service delivery and practice, and service costs and caseload. WP2 was an observational study of three reablement services, each representing a different service model. Data were collected on health (EuroQol-5 Dimensions, five-level version) and social care related (Adult Social Care Outcomes Toolkit – self-completed) quality of life, practitioner (Barthel Index of Activities of Daily Living) and self-reported (Nottingham Extended Activities of Daily Living scale) functioning, individual and service characteristics, and resource use. They were collected on entry into reablement (n = 186), at discharge (n = 128) and, for those reaching the point on the study timeline, at 6 months post discharge (n = 64). Interviews with staff and service users explored experiences of delivering or receiving reablement and its perceived impacts. In WP3, staff in eight reablement services were interviewed to investigate their experiences of reabling people with dementia. RESULTS: A total of 201 services in 139 local authorities took part in the survey. Services varied in their organisational base, their relationship with other intermediate care services, their use of outsourced providers, their skill mix and the scope of their reablement input. These characteristics influenced aspects of service delivery and practice. The average cost per case was £1728. Lower than expected sample sizes meant that a comparison of service models in WP2 was not possible. The findings are preliminary. At discharge (T1), significant improvements in mean score on outcome measures, except self-reported functioning, were observed. Further improvements were observed at 6 months post discharge (T2), but these were significant for self-reported functioning only. There was some evidence that individual (e.g. engagement, mental health) and service (e.g. service structure) characteristics were associated with outcomes and resource use at T1. Staff’s views on factors affecting outcomes typically aligned with, or offered possible explanations for, these associations. However, it was not possible to establish the significance of these findings in terms of practice or commissioning decisions. Service users expressed satisfaction with reablement and identified two core impacts: regained independence and, during reablement, companionship. Staff participating in WP3 believed that people with dementia can benefit from reablement, but objectives may differ and expectations for regained independence may be inappropriate. Furthermore, staff believed that flexibility in practice (e.g. duration of home visits) should be incorporated into delivery models and adequate provision made for specialist training of staff. CONCLUSIONS: The study contributes to our understanding of reablement, and what the impacts are on outcomes and costs. Staff believe that reablement can be appropriate for people with dementia. Findings will be of interest to commissioners and service managers. Future research should further investigate the factors that have an impact on outcomes, and reabling people with dementia. (Edited publisher abstract)