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 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 (former - to 2023) 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 Feb 2025 03:24
URI:	https://ueaeprints.uea.ac.uk/id/eprint/12590
DOI:	10.1093/ageing/afh232

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