Search results for ‘Subject term:"older people"’ 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.
Co-production involving and led by older people: an evidence and practice review
- Authors:
- BROWN Helen, RAINES Tom
- Publisher:
- National Development Team for Inclusion
- Publication year:
- 2014
- Pagination:
- 34
- Place of publication:
- Bath
This report pulls together the evidence, outcomes and key characteristics of effective co-production involving older people. It explores: the current contexts and drivers for co-production across the UK; examines the concepts and definitions associated with co-production; offers some guiding principles and practice; summarises the evidence for co-production involving older people and what can be achieved as a result; and provides practical examples that people can use in their own work and in their local areas. It draws on work from the Wisdom in Practice initiative in Scotland which reviewed evidence and examples of co-production involving and led by older people. (Edited publisher abstract)
Evaluating the impact of the 2005 OFT study into care homes for older people
- Author:
- GHK
- Publisher:
- Great Britain. Office of Fair Trading
- Publication year:
- 2011
- Pagination:
- 124p.
- Place of publication:
- London
The Office of Fair Trading (OFT) commissioned this report to evaluate the impact of the OFT's 2005 market study into care homes for older people in the UK. The research was based on engagement with residents, a survey of care homes, a mystery shopping exercise, and a survey of local authorities. It found that: 94% of care homes say they provide residents with a contract or statement of terms and conditions, compared to 82% six years ago. Ninety per cent of mystery shopper callers were able to obtain information on fee levels, and 79% of care homes surveyed now report that they provide detailed price lists to prospective residents. Following an OFT recommendation to establish a 'one stop shop' for information, the First Stop Care Advice service was set up which, alongside the Care Information website and helpline in Scotland, has seen high rates of satisfaction. However, there was room for improvement with only 60% of care homes providing information to residents on complaints procedures. The evaluation also highlights the need to increase consumer awareness of relevant information, such as inspection reports, contracts and other sources of information when deciding on a care home.
Options for care funding: what could be done now?
- Author:
- COLLINS Sue
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2009
- Pagination:
- 7p.
- Place of publication:
- York
This overview draws on JRF’s research from its ‘Paying for long-term care’ programme to examine other funding alternatives and improvements to the current system. It also draws on the practical experience of the Joseph Rowntree Housing Trust care services to provide innovative examples from practice.
Care coordination for older people in the non-statutory sector: activities, time use and costs
- Authors:
- HUGHES Jane, et al
- Journal article citation:
- Journal of Long-Term Care, August 2020, pp.91-107. Online only
- Publisher:
- King's College London
- Place of publication:
- London
Context: Care coordination is one important mechanism to provide effective care at home for frail older people in a world with ageing populations. In England this has usually been undertaken by state funded local authority social care services. The Care Act 2014 promoted greater involvement of the non-statutory sector in the provision of care and support, including care coordination, for older people at home to offer greater flexibility and consumer choice. Objective(s): To explore how organisations in the non-statutory sector in England undertake care coordination activities, targeting, their staff time use and costs to support older people at home. Method(s): A case study approach was used involving semi-structured interviews with practitioners in 17 services selected from a national survey in 2015. Estimates of practitioner time use for a typical case, and associated costs for each service were calculated. Data were analysed to identify the range of care coordination activities undertaken, forms of targeting, patterns of staff time use and service costs. Findings: Two services undertook no targeting activities; of eight care coordination activities only two were undertaken in all services. Costs of care coordination activities varied both within and between services in two distinct settings: hospital discharge and memory services. More time was spent by practitioners in direct contact with service users and carers than on indirect activities in most care coordination services. Limitations: A case study approach is more difficult to generalise; recall bias may have influenced data on time use and costs from practitioner interviews; some costs had to be attributed using national data. Implications: Both service setting and gatekeeping mechanisms shaped care coordination activities. Where services were designed to substitute for statutory services their sustainability needs to be addressed in terms of length of contracts, extent of case responsibility and full costing. (Edited publisher abstract)
Delayed hospital discharges of older patients: a systematic review on prevalence and costs
- Authors:
- LANDEIRO Filipa, et al
- Journal article citation:
- Gerontologist, 59(2), 2019, p.e86–e97.
- Publisher:
- Oxford University Press
Purpose of the Study; To determine the prevalence of delayed discharges of elderly inpatients and associated costs. Design and Methods: Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO – CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE – Social Care Online for evidence published between 1990 and 2015 were searched on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals. Descriptive and regression analyses were conducted. Data on proportions of delayed discharges were pooled using a random effects logistic model and the association of relevant factors was assessed. Mean costs of delayed discharge were calculated in USD adjusted for Purchasing Power Parity (PPP). Results: Of 64 studies included, 52 (81.3%) reported delayed discharges as proportions of total hospital stay and 9 (14.1%) estimated the respective costs for these delays. Proportions of delayed discharges varied widely, from 1.6% to 91.3% with a weighted mean of 22.8%. This variation was also seen in studies from the same country, for example, in the United Kingdom, they ranged between 1.6% and 60.0%. No factor was found to be significantly associated with delays. The mean costs of delayed discharge also varied widely (between 142 and 31,935 USD PPP adjusted), reflecting the variability in mean days of delay per patient. Implications: Delayed discharges occur in most countries and the associated costs are significant. However, the variability in prevalence of delayed discharges and available data on costs limit our knowledge of the full impact of delayed discharges. A standardization of methods is necessary to allow comparisons to be made, and additional studies are required - preferably by disease area - to determine the postdischarge needs of specific patient groups and the estimated costs of delays. (Edited publisher abstract)
Is it time for the "care pension"?
- Author:
- ROYAL LONDON
- Publisher:
- Royal London
- Publication year:
- 2018
- Pagination:
- 15
- Place of publication:
- London
This paper, by mutual insurer Royal London, offers a potential solution to the issue of how to pay for long-term care. The paper identifies several factors which deter people from buying financial products which allow them to plan ahead for future care costs when coming up to retirement. It also highlights barriers that mean insurers have been reluctant to offer such products. The paper suggests creation of a new at-retirement product – the care pension - which would combine existing income ‘drawdown’ arrangements with insurance against future care costs. To enable the product to succeed, the paper calls on the government to introduce two policy changes: for withdrawals from the drawdown account to pay for the care insurance element to be tax free; and for there to be a lifetime cap on care costs to increase the willingness of financial services providers to offer the product. The paper has been submitted to the Government for consideration by the team preparing the proposed Green Paper on social care. (Edited publisher abstract)
Hidden hunger and malnutrition in the elderly
- Author:
- FORSEY Andrew
- Publisher:
- All-Party Parliamentary Group on Hunger
- Publication year:
- 2018
- Pagination:
- 27
The report of the All-Party Parliamentary Group on Hunger inquiry into malnutrition amongst older people. The report looks at the increasing numbers of older people experiencing malnutrition and the factors which make some groups of older people more at risk. It identifies both loneliness and isolation as two key factors contributing to malnutrition, which are often brought about by bereavement, illness, shop closures and a loss of community transport or Meals on Wheels. The report estimates the annual cost to health and social care services as £11.9 billion and argues that targeted investment in services would deliver significant annual savings to services. It also provides examples of community initiatives to improve nutrition levels among older people, such as assisted shopping, and lunch clubs. It concludes by providing a set of proposals to help counter malnutrition amongst older people for good, which include recommendations for government and supermarkets. (Edited publisher abstract)
The social value of sheltered housing: briefing paper
- Author:
- WOOD Claudia
- Publisher:
- DEMOS
- Publication year:
- 2017
- Pagination:
- 16
- Place of publication:
- London
Drawing on the findings from a review of evidence on the impact of sheltered housing for older people, this briefing paper provides estimates of the cost savings sheltered housing can achieve for health and social care. The paper gives a conservative estimate of a social value saving made by sheltered housing of nearly half a billion pounds. This figure takes into account costs saved through a reduction in the number of falls by older people, the time spent in hospital, combating loneliness, as well as fewer unnecessary call-outs to emergency services. The paper was commissioned to help Anchor, Hanover and Housing & Care 21 consider the future of sheltered housing. (Edited publisher abstract)
The homecare deficit 2016: a report on the funding of older people’s homecare across the United Kingdom
- Author:
- UNITED KINGDOM HOMECARE ASSOCIATION
- Publisher:
- United Kingdom Homecare Association
- Publication year:
- 2016
- Pagination:
- 72
- Place of publication:
- Wallington
- Edition:
- Version 1
Drawing on data obtained from freedom of information requests, this report analyses average prices paid by councils for home care services across all four administrations of the United Kingdom. It also provides a breakdown by England’s nine government regions. The data were obtained during a sample week in April 2016 following the introduction of the new National Living Wage. The analysis found that only one in ten authorities paid an average price at or above UKHCA’s minimum price of £16.70 per hour. It also found that seven authorities paid average prices which the UKHCA believe are unlikely even to cover care workers’ wages and on-costs of £11.94 per hour. Only 24 councils had completed calculations for the costs of home care. The report highlights the low rates that many councils are paying independent and voluntary homecare providers. It argues that this underfunding is a root cause of the instability of local homecare markets and the low pay and conditions of the homecare workforce. The analysis also exposes the level of risk that councils place on a system intended to support older and disabled people. The report makes a number of recommendations, which include the need for local authorities to provide calculations of their costs of homecare. (Edited publisher abstract)