Hostname: page-component-7c8c6479df-5xszh Total loading time: 0 Render date: 2024-03-29T15:52:07.826Z Has data issue: false hasContentIssue false

Cognitive disability and direct care costs for elderly people

Published online by Cambridge University Press:  03 January 2018

Shane Kavanagh
Affiliation:
London School of Economics, London
Martin Knapp*
Affiliation:
London School of Economics, London
*
Professor Martin Knapp, Personal Social Services Research Unit, London School of Economics, Houghton Street, London WC2A 2AE. e-mail: M.Knapp@lse.ac.uk

Abstract

Background

Population ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Is there an association between costs and cognitive disability?

Aims

To compare service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments.

Method

Secondary analysis of Office of Population Censuses and Surveys (OPCS) Disability Surveys data compared service utilisation and costs for 8736 elderly people with cognitive disability. Cost estimates were constructed for all health and social care services.

Results

A much greater proportion of people at higher levels of cognitive disability lived in communal establishments, where their (direct) costs were much higher than when supported in households. Service utilisation patterns and costs varied with cognitive disability.

Conclusions

It is important to look at the full range of living arrangements and support services when examining costs. The potential cost implications of pharmacotherapies, other treatments or new care arrangements cannot be appreciated without such a broad perspective.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

Funded by Janssen-Cilag and the Department of Health (London).

References

Barber, J. A. & Thompson, S. G. (1998) Analysis and interpretation of cost data in randomised controlled trials: review of published studies. British Medical Journal, 317, 11951200.CrossRefGoogle ScholarPubMed
Challis, D. J. & Davies, B. P. (1986) Case Management in Community Care. Aldershot: Gower.Google Scholar
Challis, D. J. & Davies, B. P., von Abendorff, R., Brawn, P., et al (1997) Care management and dementia: an evaluation of the Lewisham intensive care management scheme. In Dementia: Challenges and New Directions (ed. Hunter, S.). London: Jessica Kingsley.Google Scholar
Collin, C., Wade, D. T., Davies, S., et al (1988) The Barthel ADL Index: a reliability study. International Disability Studies, 10, 6163.CrossRefGoogle ScholarPubMed
Cooper, B. & Fearn, R. (1998) Dementia care needs in an area population: case register data and morbidity survey estimates. International Journal of Geriatric Psychiatry 13, 550555.Google Scholar
Darton, R. A. (1998) PSSRU survey of residential and nursing home care. Mental Health Research Review, 5, 2630.Google Scholar
Ely, M. M., Melzer, D. Opit, L., et al (1997) Estimating the numbers and characteristics of elderly people with cognitive disability in local populations. Research, Policy and Planning, 14, 1318.Google Scholar
Ernst, R. L., Hay, J. W., Fenn, C., et al (1997) Cognitive function and the costs of Alzheimer's disease. Archives of Neurology 54, 687693.CrossRefGoogle Scholar
Kavanagh, S. M. & Knapp, M. R. J. (1997) The costs of external services for elderly people living in institutions. In Unit Costs of Hearth and Social Care 1997 (eds Netten, A. & Dennett, J.). Canterbury: Personal Social Services Research Unit, University of Kent.Google Scholar
Kavanagh, S. M. & Knapp, M. R. J. (1998) The impact on primary care services of the changing balance of care for elderly people living in institutions. British Medical Journal, 317, 322327.Google Scholar
Kavanagh, S. M. & Knapp, M. R. J., Schneider, J., Knapp, M. R. J., et al (1995) Elderly people with dementia: costs, effectiveness and balance of care. In Economic Evaluation of Mental Health Care (ed. Knapp, M. R. J.). Aldershot: Arena.Google Scholar
Knapp, M. R. J., Wilkinson, D. & Wigglesworth, R. (1998) The economic consequences of Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 531543.Google Scholar
McPherson, K., Sloan, R. L., Hunter, J., et al (1993) Validation studies of the OPCS Scale – more useful than the Barthel index? Clinical Rehabilitation, 7, 105112.Google Scholar
Martin, J., Meltzer, H. & Elliot, D. (1988) The Prevalence of Disability Among Adults: OPCS Surveys of Disability in Great Britain Report I. London: HMSO Google Scholar
Martin, White A. & Meltzer, H. (1989) Disabled Adults: Services, Transport and Employment: OPCS Surveys of Disability in Great Britain Report 4. London: HMSO.Google Scholar
Melzer, D., Ely, M & Brayne, C. (1997a) Cognitive impairment in elderly people: population-based estimate of the future in England. Scotland and Wales. British Medical journal, 315, 462.Google Scholar
Melzer, D., Ely, M & Brayne, C. (1997b) Local population differences and the needs of people with cognitive impairment. International journal of Geriatric Psychiatry, 12, 883887.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Netten, A. & Dennett, J. (1995) Unit Costs of Community Core 1995. Canterbury: Personal Social Services Research Unit, University of Kent.Google Scholar
Office of Population Censuses and Surveys Social Survey Division (1989) Survey of Disability Among Adults in Private Households 1985. Colchester: ESRC Data Archives.Google Scholar
Organization for Economic Cooperation and Development (1996) Care foe Frail Elderly People. Social Policy Studies 19. Paris: OECD.Google Scholar
Opit, L. J. (1998) Elderly Core Planning Model: Wessex Regional Health Authority Canterbury: Centre for Health Services Studies. University of Kent.Google Scholar
Opit, L. J. & Pahl, J. (1993) Institutional care for elderly people: can we predict admissions? Research, Policy and Planning, 10, 25.Google Scholar
Wellwood, I., Dennis, M. S. & Werlow, C. P. (1995) Comparison of the Barthel Index and the OPCS disability instrument used to measure outcome after acute stroke. Age and Ageing, 24, 5457.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.