Cost effectiveness in adult social careJennifer Francis, Research Analyst

Age NI and SCIE seminar ‘Prevention: the way forward’

21 March 2012

Overview

Why prevention? – the context The importance of cost effectiveness data Economics fit for social care What the research says about reablement What the research says about preventing

loneliness Can we ‘invest to save’?

Why prevention?

Demographic shifts People living longer Decrease in informal support

Savings drive Economic climate Public opinion

The importance of cost effectiveness data

Rationally reduce expenditure Improve people’s wellbeing

What’s involved in economic evaluation?

Analysis of cost and benefits Comparison with a control (often the usual

intervention or service) Measurement and valuation of effects vary

Economics fit for social care

The complexity of social care requires a broad analytic perspective

Outcomes should include the perspective of service users and their families

The costs of un-paid care should always be included Methods can be applied which address the lack of

evidence in social work and social care Costs and benefits should be analysed for different

sub groups of the population

The importance of costs and outcomes

“...there was no statistically significant difference in the costs of all the services used by the reablement and comparison group over the 12 month study period.”

“... the study has established a high probability of cost-effectiveness...”

Outcome measures

Perceived health Perceived quality of life Health related quality of life (EQ-5D) Social care outcomes (ASCOT)

The spectrum of prevention

Preventing loneliness and social isolation

“Primary prevention is

generally designed for

people with few health

or social care needs or

symptoms of illness”

Services included

How effective?

Reducing loneliness Community navigator, befriending.

Improving health and well-being Befriending, community activities.

Health service use Cultural programmes.

How cost-effective?

Befriending Estimated savings, £300 per person, per year

Community Navigators Economic benefit, approx £900 (year one)

Social activity groups Estimated saving of €62

Can we ‘invest to save’ in prevention?

Evidence of acceptability Some good evidence of effective

interventions Limited evidence of cost effectiveness