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Independence pays: a cost and resource analysis of direct payments in two local authorities
- Authors:
- STAINTON Tim, BOYCE Steve, PHILLIPS Ceri J.
- Journal article citation:
- Disability and Society, 24(2), March 2009, pp.161-172.
- Publisher:
- Taylor and Francis
Although there is an increasing amount of literature on direct payments (DP), to date there have been few studies which have examined in any detail the costs and resources associated with them. This paper presents findings from a two year study conducted in two Welsh local authorities that jointly fund an Independent Living Support (ILS) scheme. The main study was not designed to provide definitive cost comparisons with conventional services, however, cost and resource implications of DP were considered and an analysis to determine comparative costs between DP and traditional services was undertaken. The study notes the difficulty in identifying the true cost of DP and reasonable comparators with traditional services. A set of four case studies are presented comparing actual costs of DP and in-house and independent sector services in the two local authorities studied. The comparison of costs and resources, which did not include significant costs for traditional local authority services but included the cost of the DP support scheme, found that DP was cheaper than traditional in-house service provision and relatively cost neutral when compared with independent sector provision. User satisfaction, however, was significantly greater with DP than traditional service delivery methods. The paper also examines factors which can potentially influence the cost of DP. The study suggests that DP represent a substantial improvement over traditional arrangements from a cost-benefit perspective. There is strong evidence to suggest that greater 'opportunity cost' savings can be anticipated when DP schemes become more fully integrated into policy, practice and procedures.
Cost of community care for older people
- Authors:
- LIVINGSTON Gill, MANELA Monica, KATONA Cornelius
- Journal article citation:
- British Journal of Psychiatry, 171, July 1997, pp.56-59.
- Publisher:
- Cambridge University Press
Describes the financial cost of formal community services for elderly people with dementia, depression, anxiety disorders of physical disability. Results found that dementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. The highest service cost for the population as a whole was for the physically disabled. Concludes that failure to detect and treat depression and the anxiety disorders in older people, despite their presentation to medical services, may have major economic consequences as well as contributing to individual suffering.
How costly is it to care for disabled elders in a community setting?
- Authors:
- HARROW Brooke S., TENNSTEDT Sharon L., McKINLAY John B.
- Journal article citation:
- Gerontologist, 35(6), December 1995, pp.803-813.
- Publisher:
- Oxford University Press
Describes the total cost of care, including both informal caregiving and formal services for a cohort of disabled elderly living in the community in the USA. Increased disability was associated with increased costs. High-cost elders were more likely to be severely disabled, live with their caregiver, and become institutionalised. For most elders, even the cost of a complete substitution of informal care for formal services, plus living expenses, was less costly than nursing home care.
Where do you think you're going: summary report of the John Grooms inquiry into the needs of young disabled people
- Author:
- ACKROYD Jane
- Publisher:
- John Grooms
- Publication year:
- 2003
- Pagination:
- 11p.
- Place of publication:
- London
The inquiry found that many disabled people have problems securing services as and when they need them. The care offered frequently limits their their opportunities for personal development and social integration. In particular: More than 8,000 young adults are living in care homes designed primarily for a different client group, usually elderly people. Nearly 80% of local authorities limit the cost of community care packages and 75% of them use the cost of alternative residential care as the ceiling. There are wide discrepancies between outcomes for disabled people with similarly high needs, depending on where they live and when their support packages were first set up. There is a shortage of services that provide emotional support, mentoring and advocacy. Young people are often not involved in planning for their future, particularly if they have communication and/or cognitive difficulties. Needs assessments often focus on the services available rather than individual support requirements, choices and aspirations. Services are poorly co-ordinated and inflexible. Rules governing assessment, provision, costs, and equipment supply and maintenance differ between departments and for age groups and this makes it difficult to obtain the right services at the right time or to secure continuity of care as needs change.
Where do you think you're going: report of the John Grooms inquiry into the needs of young disabled people
- Author:
- ACKROYD Jane
- Publisher:
- John Grooms
- Publication year:
- 2003
- Pagination:
- 109p.
- Place of publication:
- London
The inquiry found that many disabled people have problems securing services as and when they need them. The care offered frequently limits their their opportunities for personal development and social integration. In particular: More than 8,000 young adults are living in care homes designed primarily for a different client group, usually elderly people. Nearly 80% of local authorities limit the cost of community care packages and 75% of them use the cost of alternative residential care as the ceiling. There are wide discrepancies between outcomes for disabled people with similarly high needs, depending on where they live and when their support packages were first set up. There is a shortage of services that provide emotional support, mentoring and advocacy. Young people are often not involved in planning for their future, particularly if they have communication and/or cognitive difficulties. Needs assessments often focus on the services available rather than individual support requirements, choices and aspirations. Services are poorly co-ordinated and inflexible. Rules governing assessment, provision, costs, and equipment supply and maintenance differ between departments and for age groups and this makes it difficult to obtain the right services at the right time or to secure continuity of care as needs change.
Cognitive disability and direct care costs for elderly people
- Authors:
- KAVANAGH Shane, KNAPP Martin
- Journal article citation:
- British Journal of Psychiatry, 174(6), June 1999, pp.539-546.
- Publisher:
- Cambridge University Press
Population ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Examines whether there is an association between costs and cognitive disability by comparing service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments. Discusses how population ageing is closely associated with higher utilisation of health and social care services, and how new treatment or service arrangements provoke debate about their cost implications. The study aims to provide 'benchmark' information to inform debates about the potential costs of various treatment and service charges.
Planning and costing community care
- Editors:
- CLARK Chris, LAPSLEY Irvine
- Publisher:
- Jessica Kingsley
- Publication year:
- 1996
- Pagination:
- 165p.,bibliogs.
- Place of publication:
- London
Draws on current research to assess the issues and problems arising as social work and services departments learn how to implement the new community care legislation. Takes as a basis the view that costing care must entail a synthesis of the various philosophies of care, entitlement and public accountability. Includes chapters on: care management; assessment; needs; costs and budgets; costing care for disabled people; and the costs of informal care.