Investigating the economic case of a service to support carers of people with dementia: A cross-sectional survey-based feasibility study in England.
Admiral Nursing
carers
costs
economic evaluation
outcomes
social care
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:
23
05
2018
revised:
27
03
2019
accepted:
12
05
2019
pubmed:
22
6
2019
medline:
5
6
2020
entrez:
22
6
2019
Statut:
ppublish
Résumé
Carers contribute essential support to enable people with dementia to continue living within the community. Admiral Nurses provide specialist dementia support for carers of people with dementia, including offering expert emotional support and guidance, and work to join up different parts of the health and social care system to address needs in a co-ordinated way. The cost-effectiveness of this service is not clear. We undertook a feasibility study to explore related outcomes and costs for these carers. A cross-sectional, clustered survey was undertaken in England in 2017, in areas with and without Admiral Nursing (AN). The survey questionnaire included questions on the characteristics of the carers and the person with dementia, outcomes (care-related quality of life [CRQoL], self-efficacy and subjective well-being), use of health and social care services, out-of-pocket costs and time spent on informal care. We used different econometric techniques to compare the outcomes and the costs of the carers with and without AN services: linear regression, propensity score matching and instrumental variables analysis. These techniques allowed us to control for differences in observed and unobserved characteristics between the two groups of carers which determined outcomes and costs. We concluded that AN services might have a positive effect on carers' CRQoL, self-efficacy and subjective well-being. Furthermore, we found little difference in costs between carers using AN and those using usual care, or in the costs of the people with dementia they care for. Our findings provided an initial indication as to whether AN services could be good value for money. The key limitation of the study was the difficulty in controlling for unobserved characteristics because of the cross-sectional nature of our observational data. To diminish this limitation, our survey could be used in future studies following carers with and without AN services over time.
Identifiants
pubmed: 31225939
doi: 10.1111/hsc.12799
pmc: PMC6771746
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e734-e743Subventions
Organisme : Department of Health
ID : HS&DR/14/154/07
Pays : United Kingdom
Organisme : Health Services and Delivery Research Programme
ID : 14/154/07
Pays : International
Organisme : National Institute for Health Research
Pays : International
Informations de copyright
© 2019 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.
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