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The future of extra care and retirement housing
- Author:
- HANOVER
- Publisher:
- Hanover Group
- Publication year:
- 2009
- Pagination:
- 9p.
- Place of publication:
- Staines
It is now 20 years since Hanover Housing Association built its first Extra Care housing project. This paper, written by Hanover’s Chair and Chief Executive, considers whether Extra Care has been a good model for providing housing for older people and if the concept of Extra Care housing is the best approach for the future. He concludes that Extra Care housing has been highly successful and meets the needs and aspirations of its residents. However, in this more austere financial environment economies are needed and this paper looks at the areas of on-site care, communal facilities, and the meal service to see where savings can be made. The aim for the future is to provide more cost-effective services that meet aspirations for independence and fit comfortably with the principles of personalisation.
Release the pressure
- Authors:
- BOLOT Tim, PHILLIPS Scott
- Journal article citation:
- Health Service Journal, 123(6357), 28 June 2013, p.32.
- Publisher:
- Emap Healthcare
Highlights key lessons from US regulators that could help inform the UK care home sector. The first, that in the long run providing health and social care services in the home are much less expensive and more effective than providing them in a hospital or care home setting. The second, than individuals must be expected to assume some responsibility for their housing needs in old age, not all can be met by the government. Developments in the US have resulted in expanding privately assisted living (residential and social care); focusing on delivering economies of scale; and moving activity to the lowest cost setting that is appropriate. (Original abstract)
The business case for social work with adults: a discussion paper
- Author:
- COLLEGE OF SOCIAL WORK
- Publisher:
- College of Social Work
- Publication year:
- 2012
- Pagination:
- 18p.
- Place of publication:
- London
The care and support White Paper, Caring for our Future, says: “Social workers have a crucial role to play in the reformed care and support system.” The College of Social Work agrees, but in a climate of austerity social work must be able to show not just that it makes a unique contribution to the lives of service users but that it makes financial sense too. This report suggests that investing in social work not only promotes the care and dignity of service users but is a cost effective way of meeting the growing need for older people’s social care. It also states that this year’s spend on older people’s social care nationwide has fallen half a billion pounds short of maintaining the levels in place when the Coalition came to power in 2010.
Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis
- Authors:
- KNAPP Martin, et al
- Journal article citation:
- British Journal of Psychiatry, 188(6), June 2006, pp.574-580.
- Publisher:
- Cambridge University Press
Psychological therapy groups for people with dementia are widely used, but their cost-effectiveness has not been explored. The aim was to investigate the cost-effectiveness of an evidence-based cognitive stimulation therapy (CST) programme for people with dementia as part of a randomised controlled trial. A total of 91 people with dementia, living in care homes or the community, received a CST group intervention twice weekly for 8 weeks; 70 participants with dementia received treatment as usual. Service use was recorded 8 weeks before and during the 8-week intervention and costs were calculated. A cost-effectiveness analysis was conducted with cognition as the primary outcome, and quality of life as the secondary outcome. Cost-effectiveness acceptability curves were plotted. Cognitive stimulation therapy has benefits for cognition and quality of life in dementia, and costs were not different between the groups. Under reasonable assumptions, there is a high probability that CST is more cost-effective than treatment as usual, with regard to both outcome measures. Cognitive stimulation therapy for people with dementia has effectiveness advantages over, and may be more cost-effective than, treatment as usual.
The roles of motivational interviewing and self-efficacy on outcomes and cost-effectiveness of a community-based exercise intervention for inactive middle-older aged adults
- Authors:
- GALBRAITH Niall, ROSE Catharine, ROSE Peter
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.e1048-e1060.
- Publisher:
- Wiley
Increasing physical activity (PA) among inactive middle-older aged adults in rural communities is challenging. This study investigates the efficacy of a PA intervention supporting inactive adults in rural/semirural communities. Inactive participants enrolled on either a single signposting session (n =427) or a multisession pathway combining signposting with motivational interviewing (MI; n = 478). Pre-post outcomes data assessed activity levels (International Physical Activity Questionnaire-Short Form; Single Item Sport England Measure), self-efficacy (New General Self-Efficacy scale [NGSE]) and well-being (five-item World Health Organization Well-Being Index [WHO-5]). Measures were repeated at longitudinal time points (26, 52 weeks) for the MI pathway. Outcomes were contrasted with results from an unmatched comparison group receiving treatment as usual (TAU). Cost-utility (quality-adjusted life years [QALY]-incremental cost-effectiveness ratio) and return on investment (NHS-ROI; QALY-ROI) were estimated for short (5 years), medium (10 years) and long (25 years) time horizons. Both pathways significantly increased participants' PA. The MI pathway resulted in significantly greater increases in PA than signposting-only and TAU. Improvements in psychological outcomes (NGSE; WHO-5) were significantly greater in the MI pathway than TAU. Longitudinal results indicated MI pathway participants sustained increases in light-intensity PA at 52 weeks (p < 0.001; urn:x-wiley:09660410:media:hsc13510:hsc13510-math-0001 = 0.16). Regression analyses found baseline self-efficacy predicted increased PA at 52 weeks, while baseline well-being did not. The relationship between self-efficacy and PA increased successively across time points. However, magnitude of participants' increased self-efficacy did not predict PA at any time point. Both pathways were cost-effective and cost -saving for participants aged ≥61 years from the short time horizon, with the MI pathway having greater ROI estimates. Overall, MI increased efficacy of a signposting PA intervention and was cost-saving for older adults. (Edited publisher abstract)
Is comprehensive geriatric assessment hospital at home a cost-effective alternative to hospital admission for older people?
- Authors:
- SINGH Surya, et al
- Journal article citation:
- Age and Ageing, 51(1), 2022, p.afab220.
- Publisher:
- Oxford University Press
Background: hospital level healthcare in the home guided by comprehensive geriatric assessment (CGA) might provide a less costly alternative to hospitalisation for older people. Objective: to determine the cost-effectiveness of CGA admission avoidance hospital at home (HAH) compared with hospital admission. Design/intervention: a cost-effectiveness study alongside a randomised trial of CGA in an admission avoidance HAH setting, compared with admission to hospital. Participants/setting: older people considered for a hospital admission in nine locations across the UK were randomised using a 2:1 randomisation schedule to admission avoidance HAH with CGA (N = 700), or admission to hospital with CGA when available (N = 355). Measurements: quality adjusted life years, resource use and costs at baseline and 6 months; incremental cost-effectiveness ratios were calculated. The main analysis used complete cases. Results: adjusting for baseline covariates, HAH was less costly than admission to hospital from a health and social care perspective (mean -£2,265, 95% CI: -4,279 to -252), and remained less costly with the addition of informal care costs (mean difference -£2,840, 95% CI: -5,495 to -185). There was no difference in quality adjusted survival. Using multiple imputation for missing data, the mean difference in health and social care costs widened to -£2,458 (95% CI: -4,977 to 61) and societal costs remained significantly lower (-£3,083, 95% CI: -5,880 to -287). There was little change to quality adjusted survival. Conclusions: CGA HAH is a cost-effective alternative to admission to hospital for selected older people. (Edited publisher abstract)
Modelling the comparative costs of Namaste Care: results from the namaste care intervention UK study
- Authors:
- BRAY Jennifer, et al
- Journal article citation:
- Working with Older People, 25(2), 2021, pp.131-140.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to populate a theoretical cost model with real-world data, calculating staffing, resource and consumable costs of delivering Namaste Care Intervention UK (NCI-UK) sessions versus “usual care” for care home residents with advanced dementia. Design/methodology/approach: Data from five care homes delivering NCI-UK sessions populated the cost model to generate session- and resident-level costs. Comparator usual care costs were calculated based on expert opinion and observational data. Outcome data for residents assessed the impact of NCI-UK sessions and aligned with the resident-level costs of NCI-UK. Findings: NCI-UK had a positive impact on residents’ physical, social and emotional well-being. An average NCI-UK group session cost £220.53, 22% more than usual care, and ran for 1.5–2 h per day for 4–9 residents. No additional staff were employed to deliver NCI-UK, but staff-resident ratios were higher during Namaste Care. Usual care costs were calculated for the same time period when no group activity was organised. The average cost per resident, per NCI-UK session was £38.01, £7.24 more than usual care. In reality, costs were offset by consumables and resources being available from stock within a home. Originality/value: Activity costs are rarely calculated as the focus tends to be on impact and outcomes. This paper shows that, although not cost neutral as previously thought, NCI-UK is a low-cost way of improving the lives of people living with advanced dementia in care homes. (Edited publisher abstract)
The transformational potential of telecare
- Author:
- TUNSTALL
- Publisher:
- Tunstall
- Publication year:
- 2020
- Pagination:
- 20
- Place of publication:
- Doncaster
This report shows how advanced use of telecare is helping older people stay independent at home for longer by supporting them to feel safer and more self-sufficient. The report includes the findings from three independent studies commissioned by Tunstall, which were based in Spain and the UK. The research considers the benefits of proactive, reactive and personalised use of technology to support older people in their own homes. The findings demonstrate and quantify the ability of telecare to contribute to the aim of: better health and care outcomes, improved cost efficiencies, user and carer experience, and improved staff experience. They also show the benefits of telecare at different levels from reactive, through proactive to personalised levels. Key findings included: people staying independent at home for 8.6 months longer with telecare; emergency calls reduced by 54 percent; and £4,500 per person avoided in other social care costs annually. The findings will be relevant to commissioners and policy makers evaluating the potential either for development of existing programmes or progressing to more advanced levels of telecare. (Edited publisher abstract)
Telecare for older people: economic evidence
- Authors:
- TINELLI Michela, et al
- Publisher:
- London School of Economics and Political Science, Care Policy and Evaluation Centre
- Publication year:
- 2019
- Pagination:
- 8
- Place of publication:
- London
This summary draws on existing research findings to present economic evidence on the effectiveness and cost effectiveness of telecare for older people. The summary provides information on what telecare is, evidence on its effectiveness and cost effectiveness, the quality of evidence, and how telecare is implemented. The evidence suggests that telecare, as deployed in England at the present time, does not deliver the outcomes of effectiveness and cost-effectiveness expected. However, it is noted that whether telecare is cost-effective will depend on how it is used, and in what circumstances. It recommends that more research is carried out to evaluate technologies in use, strengthen workforce training and share learning across settings. (Edited publisher abstract)
The effectiveness of local authority social services' occupational therapy for older people in Great Britain: a critical literature review
- Authors:
- BONIFACE Gail, et al
- Journal article citation:
- British Journal of Occupational Therapy, 76(12), 2013, pp.538-547.
- Publisher:
- Sage
This literature review systematically selected, critically appraised, and thematically synthesized the post 2000 published and unpublished evidence on the effectiveness and cost effectiveness of occupational therapy interventions for older people in social care services. Identified themes established: the localized nature of social care services for older people; organizational and policy impacts on services, and factors influencing effectiveness and cost effectiveness. Although occupational therapists are increasingly involved in rehabilitation and reablement, there is a continuing focus on equipment and adaptations provision. A high level of service user satisfaction was identified, once timely occupational therapy services were received. Overall, occupational therapy in social care is perceived as effective in improving quality of life for older people and their carers, and cost effective in making savings for other social and healthcare services. However, the complex nature of social care services makes it difficult to disaggregate the effectiveness of occupational therapy from other services. (Edited publisher abstract)