title: Costs and economic consequences of a help-at-home scheme for older people in England.
abstract: Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help-at-home schemes offer a mix of community support with the aim to address a range of well-being needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals' well-being and the economic consequences for local and central government can contribute to decisions about sustainable long-term care financing. This article presents results from a mixed-methods study of a voluntary sector-provided help-at-home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care-related quality of life was measured with the Adult Social Care Outcomes Toolkit for 24 service users (59% response rate) when they started using the scheme and 4-6 months later. A customised questionnaire that captured resource use and well-being information was sent to 1064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1568 per person from a local government and National Health Service (NHS) perspective and £3766 from the perspective of the individual. An expenditure of £2851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector-run help-at-home schemes to an affordable welfare system for ageing societies.
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Annette
authors.initials: A
authors.lastname: Bauer
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Gerald
authors.initials: G
authors.lastname: Wistow
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Perkins
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: King
authors.affiliation: London School of Economics and Political Science, Personal Social services Research Unit, London, UK.
authors.forename: Valentina
authors.initials: V
authors.lastname: Iemmi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D004739:England; D005260:Female; D005102:Health Expenditures; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: costs; economic; home; independent living; older people; third sector