Occupational therapy compared with social work assessment for older people. An economic evaluation alongside the CAMELOT randomised controlled trial

Flood, Chris, Mugford, Miranda, Stewart, Sandra, Harvey, Ian, Poland, Fiona ORCID: https://orcid.org/0000-0003-0003-6911 and Lloyd-Smith, Walter (2004) Occupational therapy compared with social work assessment for older people. An economic evaluation alongside the CAMELOT randomised controlled trial. Age and Ageing, 34 (1). pp. 47-52. ISSN 1468-2834

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Abstract

Objectives: to compare costs and outcome of occupational therapy-led assessment with social worker-led assessment of older people, in terms of their independence and quality of life. Design: cost-effectiveness analysis alongside a randomised controlled trial. The analysis took viewpoints of health services and patients. The primary outcome measure for cost-effectiveness was dependency using the Community Dependency Index (CDI). Secondary outcomes included utility scores based on the EuroQoL (EQ-5D). Resource use was measured for each patient, from clinical records and from patient carer interviews at 8 months. Unit costs of health and social care resources were derived from local sources and national datasets. Cost-effectiveness was analysed using cost-effectiveness acceptability curves. Results: there were no differences between the two arms of the trial in terms of cost-effectiveness. There is an apparent increase in mean cost per case for the occupational therapy arm but this is not statistically significant (mean difference in cost per case £542, 95% CI £434–1,519). Mean total costs of care per participant were £4,379 and £3,837 for the occupational therapy and social work arms, respectively. At best the intervention would improve outcomes at a cost of £14,000 per quality-adjusted life year (QALY). The probability of such an outcome was <50%. Conclusions: from a policy perspective, the lack of difference in clinical and cost-effectiveness means that either a social work or an occupational therapy service is successful in making care assessments that enable an older person to remain in their own home.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Medicine and Health Sciences > School of Rehabilitation Sciences (former - to 2014)
Faculty of Medicine and Health Sciences > Allied Health Professions (former - to 2013)
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research
Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Depositing User: EPrints Services
Date Deposited: 25 Nov 2010 11:09
Last Modified: 06 Mar 2023 16:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/12590
DOI: 10.1093/ageing/afh232

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