Cost‐minimisation analysis of home care reablement for older people in England

A modelling study

Bibliographic Data

ID12289970
AuthorsAnnette Bauer (0000-0001-5156-1631, Personal Social Services Research Unit London School of Economics and Political Science London United Kingdom, corresponding author), Jose-Luis Fernandez (0000-0002-4190-7341, London School of Economics and Political Science), Jose‐Luis Fernandez (Personal Social Services Research Unit London School of Economics and Political Science London United Kingdom), Catherine Henderson (0000-0003-4340-4702, London School of Economics and Political Science), Cate Henderson (Personal Social Services Research Unit London School of Economics and Political Science London United Kingdom), Raphael Wittenberg (0000-0003-3096-2721, Personal Social Services Research Unit London School of Economics and Political Science London United Kingdom), Mel Knapp (0000-0003-1427-0215, Personal Social Services Research Unit London School of Economics and Political Science London United Kingdom)
Year2019
Volume27
Issue5
Pages1241-1250
Publication date2019-04-21
Open AccessYes
TypeARTICLE
VenueHealth & Social Care in the Community (JOURNAL)
Journal identifiersISSN: 0966-0410 • E-ISSN: 1365-2524
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hsc.12756
PMID31006936
OpenAlexW2941642886
LanguageEN
Citations received1
References cited13

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

Confidence interval · Cost effectiveness · Cost–utility analysis · Guideline · Health care · Minimisation (clinical trials · Older people · Frailty in Older Adults · Geriatric Care and Nursing Homes · Health Systems, Economic Evaluations, Quality of Life · Medicine · Gerontology

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