Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2025-01-03T14:55:10.516Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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 

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

Court, C. (1995) Caring for the carers, British Medical Journal, 310, 616.Google Scholar
Cullen, M., Blizard, R., Livingston, G., et al (1993) The Gospel Oak Project 1987–1990: provision and use of community services. Health Trends, 25, 142–146.Google ScholarPubMed
Foulds, G. A. (1976) The Hierarchical Nature of Personal Illness. London: Academic Press.Google Scholar
Gray, A. & Fenn, P. (1993) Alzheimer's disease: the burden of the illness in England. Health Trends, 25, 31–37.Google Scholar
Gurtend, B., Golden, R., Teresi, J. A., et al (1984) The Short-CARE. An efficient instrument for the assessment of depression and dementia. Journal of Gerontology, 39, 166–169.Google Scholar
Jarman, B. (1983) Identification of underprivileged areas. British Medical Journal. 286, 1705–1709.Google Scholar
Kavanagh, S., Schneider, J., Knapp, M., et al (1993) Elderly people with cognitive impairment: costing possible changes in the balance of care. Health and Social Care in the Community, 1, 69–80.Google Scholar
Keen, J. (1993) Dementia: questions of cost and value. International Journal of Geriatric Psychiatry, 8, 369–378.Google Scholar
Lindesay, J., Briggs, C. & Murphy, E. (1989) The Guy's Age Concern Survey. Prevalence rates of cognitive impairment, depression and anxiety in an urban elderly community. British Journal of Psychiatry, 155, 317–329.Google Scholar
Livingston, G., Thomas, A., Graham, N., et al (1989) The Gospel Oak Project: the use of services by dependent elderly people in the community. Health Trends, 22, 70–73.Google Scholar
Manela, M., Ketone, C. & Livingston, G. (1996) How common are the anxiety disorders in old age? International Journal of Geriatric Psychiatry, 11, 65–70.3.0.CO;2-M>CrossRefGoogle Scholar
Melzer, D., Hopkins, S., Pencheon, D., et al (1995) Epidemiologically Based Needs Assessment. Report no. 5, Dementia 23. London: NHS Management Executive.Google Scholar
Netten, A. (1994) Unit Costs of Community Care. University of Kent: PSSRU.Google Scholar
Norusis, M. J. (1991) SPSS/PC 4. Chicago: SPSS Inc.Google Scholar
Office of Population Censuses and Surveys (1986) The General Household Survey London: HMSO.Google Scholar
Norusis, M. J. (1987) The General Household Survey London: HMSO.Google Scholar
Philp, I., McKee, K. J., Meldrum, P., et al (1995) Community care for demented and non-demented elderly people: a comparison study of financial burden, service use, and unmet needs in family supporters. British Medical Journal, 310, 1503–1506.CrossRefGoogle ScholarPubMed
Spoar, C. (1988) Care of the Elderly with Psychiatric Disorders. SOAP no. 11. University of Aberdeen: Health Economic Research Unit.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.