Cost-minimisation analysis of home care reablement for older people in England: A modelling study.
Markov decision model
cost-minimisation
economic evaluation
independent living
older people
reablement
Journal
Health & social care in the community
ISSN: 1365-2524
Titre abrégé: Health Soc Care Community
Pays: England
ID NLM: 9306359
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
18
07
2018
revised:
09
03
2019
accepted:
13
03
2019
pubmed:
23
4
2019
medline:
29
5
2020
entrez:
23
4
2019
Statut:
ppublish
Résumé
Many governments have introduced or encouraged home-care reablement schemes for older people at home with the aim of improving outcomes and reducing costs. We examined if such schemes have the potential to reduce costs from the perspective of the National Health Service (NHS) and Personal Social Services (PSS) in England. Our study was carried out to inform recommendations of a national guideline. Cost-minimisation analysis was carried out using decision-analytic Markov modelling. Home-care reablement was compared with standard home care. Costs included those of the intervention, home care and hospital admission. Uncertainty was explored using univariate and probabilistic sensitivity analysis. Mean costs per person were £56,499 (95% confidence interval 55,690 to 57,307) in the reablement group, and £58,560 (95% confidence interval 57,800 to 59,319) in the standard care group. The mean difference was -£2,061 (95% confidence interval 1,933 to 2,129). The probability that home-care reablement costs less than standard home care was 94.5% (95% confidence interval 93.1 to 95.9). In sensitivity analyses, this probability remained above 85% in all scenarios. Home-care reablement can be a successful cost-minimisation strategy for supporting some older people. More research is needed about the impact of home-care reablement on health outcomes for different groups of older people; and the effects of different durations of reablement on outcomes and costs for different subpopulations.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1241-1250Subventions
Organisme : National Institute for Health and Care Excellence
ID : NG74
Pays : International
Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Bardsley, M., Georghiou, T., Chassin, L., Lews, G., Steventon, A., & Dixon, J. (2012). Overlap of hospital use and social care in older people in England. Journal of Health Services Research & Policy, 17, 133-139.
Bebbington, A., Darton, R., & Netten, A. (2001). Care Homes for Older People. Volume 2. Admissions, needs and outcomes. Canterbury: Personal Social Services Research Unit, University of Kent at Canterbury.
Cochrane, A., Furlong, M., McGilloway, S., Molloy, D. W., Stevenson, M., & Donnelly, M.. (2016). Time-limited home-care reablement services for maintaining and improving the functional independence of older adults. Cochrane Database of Systematic Reviews, 10, Art.No.: CD010825. https://doi.org/10.1002/14651858.CD010825.pub2.
Curtis, L., & Burns, A. (2015). Unit Costs of Health and Social Care 2015. Canterbury: Personal Social Services Research Unit, University of Kent at Canterbury.
Damery, S., Flanagan, S., & Combes, G. (2016). Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews. British Medical Journal Open. https://doi.org/10.1136/bmjopen-2016-011952
Faria, R., Kiss, N., Aspinal, F. J., Harden, M., & Weatherly, H. L. A. (2015). Economic evaluation of social care interventions: Lessons drawn from a systematic review of the methods used to evaluate reablement. Health Economics & Outcome Research: Open Access, https://doi.org/10.4172/heor.1000107
Glendinning, C., Jones, K., Baxter, K., Rabiee, P., Curtis, L. A., Wilde, A., … Forder, J. E. (2010). Home care re-ablement services: investigating the longer-term impacts (prospective longitudinal study). York: Social Policy Research Unit: University of York.
HSCI. (2015). Community care statistics, social services activity, England 2014-15. London: Health and Social Care Information Centre. https://digital.nhs.uk/catalogue/PUB18663
IPC. (2011). People who pay for care: quantitative and qualitative analysis of self-funders on the social care market. Oxford: Institute for Public Care, Oxford Brooks University. http://ipc.brookes.ac.uk/publications/pdf/People_who_pay_for_care_-_report_12_1_11_final.pdf
Knapp, M., Chua, K.-C., Broadbent, M., Chang, C.-K., Fernandez, J.-L., Milea, D., … Hayes, R. D. (2016). Predictors of care home and hospital admissions and their costs for older people with Alzheimer's disease: Findings from a large London case register. British Medical Journal Open, https://doi.org/10.1136/bmjopen-2016-013591
Legg, L., Gladman, J., Drummond, A., & Davidson, A. (2016). A systematic review of the evidence on home care reablement services. Clinical Rehabilitation, 30, 741-749. https://doi.org/10.1177/0269215515603220
Lewin, G., Allan, J., Patterson, C., Knuiman, M., Boldy, D., & Hendrie, D. (2014). A comparison of the home-care and healthcare service use and costs of older Australians randomised to receive restorative or a conventional home-care services. Health & Social Care in the Community, 22, 328-336. https://doi.org/10.1111/hsc.12092
Lewin, G., De San Miguel, K., Knuiman, M., Alan, J., Boldy, D., Hendrie, D., & Vandermeulen, S. (2013). A randomised controlled trial of the Home Independence Program, an Australian restorative home-care programme for older adults. Health & Social Care in the Community, 21, 69-78. https://doi.org/10.1111/j.1365-2524.2012.01088.x
Lewin, G., & Vandermeulen, S. (2010). A non-randomised controlled trial of the Home Independence Program (HIP): An Australian restorative programme for older home-care clients. Health & Social Care in the Community, 18, 91-99. https://doi.org/10.1111/j.1365-2524.2009.00878.x
Mishra, V., & Barratt, J. (2016). Reablement and older people. IFA Copenhagen 2016 Summit Final Report. Copenhagen: IFA and DaneAge.
NAIC. (2015). National Audit of Intermediate Care Summary Report 2015. London: NHS Benchmarking Network. https://static1.squarespace.com/static/58d8d0ffe4fcb5ad94cde63e/t/58f08efae3df28353c5563f3/1492160300426/naic-report-2015.pdf
NHS Digital. (2014a). Hospital Episodes Statistics, Admitted Patient Care, England, 2013-2014. NHS Digital. https://digital.nhs.uk/catalogue/PUB16719
NHS Digital. (2014b). Personal social services: Expenditure and unit costs, England, 2013-14 final release. London: NHS Digital, 2014. https://files.digital.nhs.uk/publicationimport/pub16xxx/pub16111/pss-exp-eng-13-14-fin-rpt.pdf
NICE. (2014a). Home care: delivering personal care and practical support to older people living in their own homes: Scope consultation comments table. London: National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng21/documents/home-care-scope-consultation-comments-table2
NICE. (2014b), Developing NICE Guidelines: The Manual. London: National Institute for Health and Care Excellence. https://www.nice.org.uk/process/pmg20/chapter/incorporating-economic-evaluation
NICE. (2018). Intermediate care including reablement. NG74. London, UK: National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/NG74
ONS. (2015a). Annual mid-year population estimates UK: 2014. London: Office for National Statistics. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/2015-06-25
ONS. (2015b). Deaths Registered in England and Wales: 2014, Deaths, stillbirths and infant mortality including death rates, causes, age, and area of residence. London: Office for National Statistics. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2015-07-15
Pearson, M., Hunt, H., Cooper, C., Shepperd, S., Pawson, R., & Anderson, R. (2015). Providing effective and preferred care closer to home: A realist review of intermediate care. Health & Social Care in the Community, 23, 577-593. https://doi.org/10.1111/hsc.12183
Rostgaard, T., Glendinning, C., Gori, C., Kroger, T., Osterle, A., Szebehely, M., … Vaboa, M. (2011). Livindhome: Living independently at home. Reforms in home care in 9 European countries. Copenhagen: Danish National Centre for Social Research.
Samuel, M.. (2010). What is reablement? In: Adults, Domiciliary care, Legal, Mental Health, Older people, Workforce. Community Care. www.communitycare.co.uk/2010/09/20/what-is-reablement/
Sculpher, M. (2004). The use of probabilistic sensitivity analysis for decision making: The example of drug-eluting stents. Cambridge, Massachusetts: Seminar at Harvard Clinical Research Institute, Harvard University.
Senior, H. E., Parsons, M., Kerse, N., Chen, M. H., Jacobs, S., Hoorn, S. V., & Anderson, C. S. (2014). Promoting independence in frail older people: A randomised controlled trial of a restorative care service in New Zealand. Age & Ageing, 43, 418-424. https://doi.org/10.1093/ageing/afu025
Tessier, A., Beaulieu, M. D., McGinn, C. A., & Latulippe, R. (2016). Effectiveness of reablement: A systematic review. Healthcare Policy, 11, 49-59. https://doi.org/10.12927/hcpol.2016.24594
The EuroQol Group. (1990). EuroQol-a new facility for the measurement of health-related quality of life. Health Policy, 16, 199-208.
Tinetti, M. E., Charpentier, P., Gottschal, M., & Baker, D. I. (2012). Effect of a restorative model of post hospital home care on hospital readmissions. Journal of the American Geriatrics Society, 60, 1521-1526. https://doi.org/10.1111%2Fj.1532-5415.2012.04060.x
Tuntland, H., Aaslund, M. K., Espehaug, B., Førland, O., & Kjeken, I. (2015). Reablement in community-dwelling older adults: A randomised controlled trial. BMC Geriatrics, 15, 145. https://doi.org/10.1186/s12877-015-0142-9
Whitehead, P. J., Worthington, E. J., Parry, R. H., Walker, M. F., & Drummond, A. E. (2015). Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: A systematic review. Clinical Rehabilitation, 29, 1064-1076. https://doi.org/10.1177/0269215514564894
Xie, C., Hughes, J., Sutcliffe, C., Chester, H., & Challis, D. (2012). Promoting personalization in social care services for older people. Journal of Gerontological Social Work, 55, 218-232. https://doi.org/10.1080/01634372.2011.639437
York Health Economics Consortium. (2016), Probabilistic/Stochastic Sensitivity Analysis [online]. https://www.yhec.co.uk/glossary/probabilisticstochastic-sensitivity-analysis/