Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T08:41:59.645Z Has data issue: false hasContentIssue false
  • English
  • Français

An economic analysis of a community-based model for dementia care in Ireland: a balance of care approach

Published online by Cambridge University Press:  28 March 2017

Eamon O'Shea  and
Christine Monaghan
Eamon O'Shea*
Affiliation:
Centre for Economic and Social Research on Dementia, National University of Ireland, Galway, Galway, Ireland
Christine Monaghan
Affiliation:
Centre for Economic and Social Research on Dementia, National University of Ireland, Galway, Galway, Ireland
*
Correspondence should be addressed to: Eamon O'Shea, Centre for Economic and Social Research on Dementia, National University of Ireland, Galway, Galway, Ireland. Phone: +353-91-49-5461. Email: eamon.oshea@nuigalway.ie.
Get access

Abstract

Background:

This study examined resource utilization, cost of care, and balance of care relationships for people with dementia on the boundary of community and residential care in Ireland.

Methods:

A balance of care approach was used to examine how investment in personalized community care impacted on measured formal and informal costs, care relationships, and potential admission to long-stay care facilities for people with dementia over a three year period.

Results:

181 people with dementia on the boundary of community and residential care received additional personalized care supports to help them remain living at home in the community. The estimated average weekly cost of community care for these people, including usual formal care provision, new personalized supports, consumption, and housing, was €418 per week, less than half the cost of potential residential care. However, when informal care is valued using an opportunity cost methodology, the social cost of community-based care increased threefold, rising above the cost of alternative residential care.

Conclusion:

Investment in personalized supports can support family carers to continue caring for longer, thus postponing expensive admission into long-stay care facilities. However, family-care costs remain high, irrespective of the additional supports received.

Keywords

dementiaboundary of carepersonalized supportsresource utilizationcommunity-based dementia carecost of care
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1175 - 1184
Copyright
Copyright © International Psychogeriatric Association 2017 

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.)

References

Afram, B. et al. (2014). Reasons for institutionalization of people with dementia: informal caregiver reports from 8 European countries. Journal of the American Medical Directors Association, 15, 108–116.CrossRefGoogle ScholarPubMed
Bartlett, R. and O'Connor, D. (2010). Broadening the Dementia Debate: Towards Social Citizenship (1st ed.). Bristol: The Policy Press.Google Scholar
Blackwell, J., O'Shea, E., Moane, G. and Murray, P. (1992). Care Provision and Cost Measurement: Dependent Elderly People at Home and in Geriatric Hospitals (1st ed.). Dublin: Economic and Social Research Institute.Google Scholar
Cahill, S., O'Shea, E. and Pierce, M. (2012). Creating Excellence in Dementia Care. A Research Review for Ireland's National Dementia Strategy (1st ed.). Galway: Irish Centre for Social Gerontology, NUI Galway.Google Scholar
Central Statistics Office (2010). Household Budget Survey 2009-2010 Volume 2-Average Household Size, Composition, Income and Expenditure Classified by Livelihood Status of Reference Person, 2009–2010. Dublin, Ireland: Central Statistics Office.Google Scholar
Central Statistics Office (2014). Earnings and Labour Costs, 2013. Dublin, Ireland: Central Statistics Office.Google Scholar
Challis, D. and Hughes, J. (2002). Frail old people at the margins of care: some recent research findings. The British Journal of Psychiatry, 180, 126–130.CrossRefGoogle ScholarPubMed
Challis, D. and Hughes, J. (2003). Residential and nursing home care—issues of balance and quality of care. International Journal of Geriatric Psychiatry, 18, 201–204.CrossRefGoogle ScholarPubMed
Clarkson, P. et al. (2015). A protocol for a systematic review of effective home support to people with dementia and their carers: components and impacts. Journal of Advanced Nursing, 72, 186–196.CrossRefGoogle ScholarPubMed
Colombo, F., Ana, L.-N. Jérôme, M. and Frits, T. (2011). OECD Health Policy Studies. Help Wanted? Providing and Paying for Long-Term Care: Providing and Paying for Long-Term Care. Paris: OECD Publishing.CrossRefGoogle Scholar
Connolly, S., Gillespie, P. O'Shea, E., Cahill, S. and Pierce, M. (2014). Estimating the economic and social costs of dementia in Ireland. Dementia, 13, 5–22.CrossRefGoogle ScholarPubMed
Donnelly, S., O'Brien, M., Begley, E. and Brennan, J. (2016). Enabling older people to access their expressed preference for care and support: a social work perspective. Age and Ageing, 45, Supplement_2 ii1–ii12.Google Scholar
Drummond, M., O'Brien, B., Stoddart, G., Torrance, G. and Sculpher, M. (2005). Methods for the Economic Evaluation of Health Care Programmes. New York: Oxford University Press.Google Scholar
Gillespie, P. et al. (2015). Longitudinal costs of caring for people with Alzheimer's disease. International Psychogeriatrics, 27, 847–856.CrossRefGoogle ScholarPubMed
Health Information and Quality Authority (2015). Guidance on Budget Impact Analysis of Health Technologies in Ireland.Dublin: Stationery Office.Google Scholar
Johnston, B. and Narayanasamy, M. (2016). Exploring psychosocial interventions for people with dementia that enhance personhood and relate to legacy-an integrative review. BMC Geriatrics, 16, 1.CrossRefGoogle ScholarPubMed
Leicht, H. et al. (2013). Predictors of costs in dementia in a longitudinal perspective. PLoS ONE, 8, e70018. doi:10.1371/journal.pone.0070018 Google Scholar
OECD (2015). Addressing Dementia: The OECD Response, in OECD Health Policy Studies. Paris: OECD Publishing.Google Scholar
O'Shea, E., Gannon, B. and Kennelly, B. (2008). Eliciting preferences for resource allocation in mental health care in Ireland. Health Policy, 88, 359–370.CrossRefGoogle ScholarPubMed
O'Shea, E. and Monaghan, C. (2015). Genio Dementia Programme Evaluation of Year 2. Irish Centre for Social Gerontology. Galway: NUI Galway.Google Scholar
O'Shea, E. and Murphy, , , E. (2014). Genio Dementia Programme Evaluation of Year 1. Irish Centre for Social Gerontology. Galway: NUI Galway.Google Scholar
Prince, M., Wimo, A. Guerchet, M. Ali, G., Wu, Y. and Prina, M. (2015). World Alzheimer Report 2015, in The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer's Disease International.Google Scholar
Schaller, S., Mauskopf, J., Kriza, C., Wahlster, P. and Kolominsky-Rabas, P. L. (2015). The main cost drivers in dementia: a systematic review. International Journal of Geriatric Psychiatry, 30, 111–129.CrossRefGoogle ScholarPubMed
Spijker, A. et al. (2008). Effectiveness of nonpharmacological interventions in delaying the institutionalization of patients with dementia: a meta-analysis. Journal of the American Geriatrics Society, 56, 1116–1128.CrossRefGoogle ScholarPubMed
Tucker, S., Hughes, J., Burns, A. and Challis, D. (2008). The balance of care: reconfiguring services for older people with mental health problems. Aging and Mental Health, 12, 81–91.Google Scholar
Tucker, S. et al. (2016). Improving the mix of institutional and community care for older people with dementia: an application of the balance of care approach in eight European countries. Aging & Mental Health, 20, 1327–1338. Epub 2015 Sep 1.Google Scholar
Van den Berg, B., Brouwer, W. B. and Koopmanschap, M. A. (2004). Economic valuation of informal care. The European Journal of Health Economics, 5, 36–45.Google Scholar
Wimo, A. (2010). The art of cost of illness. Journal of Alzheimer's Disease, 19, 617–619.Google Scholar
Wübker, A. et al. (2015). Costs of care for people with dementia just before and after nursing home placement: primary data from eight European countries. The European Journal of Health Economics, 16, 689–707.CrossRefGoogle ScholarPubMed