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Cost of community care for older people

Published online by Cambridge University Press:  03 January 2018

Gill Livingston ,
Monica Manela  and
Cornelius Katona
Gill Livingston*
Affiliation:
University College London Medical School, Middlesex Site, London
Monica Manela
Affiliation:
University College London Medical School, Middlesex Site, London
Cornelius Katona
Affiliation:
University College London Medical School, Middlesex Site, London
*
Dr G. Livingston, Department of Psychiatry, University College London Medical School, Wolfson Building, Middlesex Site. London WIN 8AA
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Abstract

Background

There has been no published study that considers actual costs in a representative sample of people aged ???? 65 years. The present study describes the financial cost of formal community services for elderly people with dementia, depression, anxiety disorders or physical disability.

Method

Psychiatric morbidity, physical disability and services received were assessed by standardised questionnaire in randomly selected Islington enumeration districts. Subjects were interviewed at home (.=700).

Results

Dementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. Despite presenting to health services, 90% were not treated with appropriate drugs. In contrast, social services were received by people who were activity-limited or with dementia. The highest service cost for the population as a whole was for the physically disabled. In multivariate analysis the significant predictors of high service costs were living alone, being physically ill, depression, dementia and increasing age.

Conclusions

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.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 1 , July 1997 , pp. 56 - 59
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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