https://tud.qucosa.de/api/qucosa%3A26871/attachment/ATT-0/

Cost of disorders of the brain in Europe 2010

Aims To estimate the current and future economic burdens of Type 1 and Type 2 diabetes in the UK. Methods A top-down approach was used to estimate costs for 2010 ⁄2011 from aggregated data sets and literature. Prevalence and population data were used to project costs for 2035 ⁄2036. Direct health costs were estimated from data on diagnosis, lifestyle interventions, ongoing treatment and management, and complications. Indirect costs were estimated from data on mortality, sickness, presenteeism (potential loss of productivity among people who remain in work) and informal care. Results Diabetes cost approximately £23.7bn in the UK in 2010 ⁄2011: £9.8bn in direct costs (£1bn for Type 1 diabetes and £8.8bn for Type 2 diabetes) and £13.9bn in indirect costs (£0.9bn and £13bn). In real terms, the 2035 ⁄2036 cost is estimated at £39.8bn: £16.9bn in direct costs (£1.8bn for Type 1 diabetes and £15.1bn for Type 2 diabetes) and £22.9bn in indirect costs (£2.4bn and £20.5bn). Sensitivity analysis applied to the direct costs produced a range of costs: between £7.9bn and £11.7bn in 2010 ⁄2011 and between £13.8bn and £20bn in 2035 ⁄2036. Diabetes currently accounts for approximately 10% of the total health resource expenditure and is projected to account for around 17% in 2035 ⁄2036. Conclusions Type 1 and Type 2 diabetes are prominent diseases in the UK and are a significant economic burden. Data differentiating between the costs of Type 1 and Type 2 diabetes are sparse. Complications related to the diseases account for a substantial proportion of the direct health costs. As prevalence increases, the cost of treating complications will grow if current care regimes are maintained. Diabet. Med. 29, 855‐862 (2012)

/pdf/article-health-economics-estimating-the-current-and-future-37respko1g.pdf

Article: Health Economics Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs

Background: Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the scientific literature over the past decade. Methods: A systematic literature search was performed for papers on home care published in English, using the following data bases: Cinahl, the Cochrane Library, Embase, Medline, PsycINFO, Sociological Abstracts, Social Services Abstracts, and Social Care Online. Studies were only included if they complied with the definition of home care, were published between January 1998 and October 2009, and dealt with at least one of the 31 specified countries. Clinical interventions, instrument developments, local projects and reviews were excluded. The data extracted included: the characteristics of the study and aspects of home care ‘policy & regulation’, ‘financing’, ‘organisation & service delivery’, and ‘clients & informal carers’. Results: Seventy-four out of 5,133 potentially relevant studies met the inclusion criteria, providing information on 18 countries. Many focused on the characteristics of home care recipients and on the organisation of home care. Geographical inequalities, market forces, quality and integration of services were also among the issues frequently discussed. Conclusions: Home care systems appeared to differ both between and within countries. The papers included, however, provided only a limited picture of home care. Many studies only focused on one aspect of the home care system and international comparative studies were rare. Furthermore, little information emerged on home care financing and on home care in general in Eastern Europe. This review clearly shows the need for more scientific publications on home care, especially studies comparing countries. A comprehensive and more complete insight into the state of home care in Europe requires the gathering of information using a uniform framework and methodology.

/pdf/home-care-in-europe-a-systematic-literature-review-4wgiv13vhz.pdf

Home care in Europe: a systematic literature review

s published since July 2011. We identified 264 relevant publications where the primary analysis involved the use of HES APC data, and a further 130 papers where HES data had been linked to cohorts created in other datasets. The annual number of publications using HES APC data has increased from 2 in 1993 to 88 in 2015. Published studies using HES APC data have covered a diverse range of topics. They have explored the incidence of conditions across regions and over time. They have also examined cross-sectional and longitudinal patterns of treatment by organization, including comparing NHS and privately contracted providers or regions, both from descriptive and analytical perspectives. Regional comparisons have included evaluating the impact of clinical evidence or guidelines as well as health care policies. They have examined the outcome of medical as well as surgical therapies (such as survival, short-term postoperative mortality, complications, reoperation and hospital readmissions), with some seeking to identify factors that are associated with these outcomes, in terms of both patient characteristics and organizational factors such as surgical volume or day of week. Methodological studies include creating coding frameworks, applying comorbidity scores, developing risk prediction models and using look-back methods to impute missing data items. Many high profile routinely produced reports on the quality of secondary care are based on HES APC data. These include hospital mortality monitoring reports produced by NHS Digital and commercial organizations, and research reports by independent think-tanks and Royal Medical Colleges. Strengths and weaknesses

/pdf/data-resource-profile-hospital-episode-statistics-admitted-bbycmkfaue.pdf

Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC).

Objective The aim of this study was to develop a measure of social care outcome, an equivalent to the quality-adjusted life year (QALY) in health, which could be used in a range of circumstances. Design The project drew on previous and parallel work developing the Adult Social Care Outcome Toolkit and the national Adult Social Care Survey. We developed and tested an instrument designed to reflect service users' social care-related quality of life (SCRQoL) and tested it with 30 service users from a variety of user groups and 300 older home care service users. In parallel, we explored discrete choice experiment (DCE) and best-worst scaling (BWS) approaches to preference elicitation with 300 members of the general population, and cognitively tested these with service users. We also cognitively tested a computer-aided time trade-off (TTO) exercise using SCRQoL attributes with members of the general population. In the second phase, using the finalised instruments, BWS interviews were conducted with 500 members of the general population, TTO interviews with a follow-up sample of 126 of these respondents, and BWS interviews with 458 people using equipment services. Main outcome measures The final measure had eight domains: personal cleanliness and comfort, accommodation cleanliness and comfort, food and drink, safety, social participation and involvement, occupation, control over daily life and dignity. In addition to measuring current SCRQoL, the instrument includes questions used to establish service users' views of their 'expected' SCRQoL in the absence of services. The difference between a person's current and 'expected' SCRQoL provides an indicator of service impact. Results There was good evidence for the validity of the descriptive system and the validity of the current, expected and SCRQoL gain scales. The DCE and BWS approaches yielded similar results and, once introductions made clear, were understood by service users. BWS was used for the main stages, as it had technical and cognitive advantages. The computer-aided approach to TTO worked well, and respondents found questions acceptable and understandable. There were no substantive differences in the preferences of service users and the general population. The key domain was control over daily life, with the lowest and highest levels strongly estimated in all models. After allowing for observable heterogeneity, service users' preferences appeared to be more closely associated with their own SCRQoL than with those of the general population. The consistency of the results with the results of a previous study allowed the final model to be based on the preferences of 1000 members of the general population. A formula based on the relationship between TTO and BWS values was estimated for a social care QALY, with '0' equivalent to 'being dead' and '1' being the 'ideal' SCRQoL state. Members of the population experienced significantly higher SCRQoL than service users. Conclusions Although further work is needed, particularly to develop an equivalent measure for informal carers and to explore the links with health QALYs, the measure has considerable potential. A number of methodological advances were achieved, including the first application of TTO in a social care context and use of BWS to establish service user preferences. Funding The National Institute for Health Research Health Technology Assessment programme.

/pdf/outcomes-of-social-care-for-adults-developing-a-preference-30bqtcakhy.pdf

Outcomes of social care for adults: developing a preference-weighted measure.

For some time now councils with social services responsibilities (CSSRs) have been required to conduct surveys of user’s experience of social services. These have taken place nationally in three-yearly cycles. In 2002/03 the survey was for older people, in 2003/04 it was for younger adults with physical and sensory impairments, and in 2004/05 it was for children. 2005/06 marked the beginning of the second wave of the cycle. The mandate for conducting surveys of user’s experiences and satisfaction with services was first given in the white paper Modern Local Government: in Touch with the People (Department for the Environment, Trade and the Regions, 1998). In 2002 the Office of National Statistics (ONS) and SPRU developed a set of questionnaires for this purpose (Qureshi and Rowlands, 2004). Subsequent national surveys have drawn on this work to identify a set of compulsory questions for each round. User experience surveys (UESs) are regarded as an important part of the overall performance framework for social care and, providing councils with information about how they might improve services locally. Local authorities are required to submit their results to government bodies so that the relative performance of the CSSRs can be judged. This report is composed of five sections. The aims and objectives of the report are outlined in the second section and the method used to gather the data is outlined in section 3. In section 4 we report on the findings from the fieldwork and draw some conclusions and recommendations for the national survey in section 5. The topic guides for the focus groups and interviews are included in the appendices along with a brief discussion of the findings from the focus groups and a copy of the final extended questionnaire.

Younger Adults' Understanding of Questions for a Service User Experience Survey. Funded/commissioned by: The Health and Social Care Information Centre

A key trend in home care in recent years in England has been movement away from "in-house" service provision by local government authorities (e.g., counties) towards models of service commissioning from independent providers. A national survey in 2003 identified that there were lower levels of satisfaction and perceptions of quality of care among older users of independent providers compared with in-house providers. This paper reports the results of a study that related service users' views of 121 providers with the characteristics of these providers. For the most part, characteristics associated with positive perceptions of quality were more prevalent among in-house providers. Multivariate analyses of independent providers suggested that aspects of the workforce itself, in terms of age and experience, provider perceptions of staff turnover, and allowance of travel time, were the most critical influences on service user experiences of service quality.

Provider and care workforce influences on quality of home care services in England

Younger adults' understanding of questions for a service user experience survey: a report to the Information Centre for Health and Social Care

In recent years, increased emphasis has been placed on consulting, involving and informing service users. A national survey in 2003 indicated that reported levels of satisfaction with services were associated with individual home care service users’ characteristics. The aim of the case study presented here was to investigate further the association between individual service user and need-related characteristics in judgements of service quality, within one local authority. Reported service quality was assessed using a measure based on items in an extended version of the 2003 User Experience Survey (UES). Additional data about service users were sought from commissioning databases and client case records. Multivariate analysis indicated a relationship between service user and need-related characteristics in the reporting of service user satisfaction. Judgements of service satisfaction were not influenced by demographic characteristics alone, but by a complex interaction between individual characteristics, situational factors, dependency characteristics and structure of the care package. This case study suggests possible explanations for individual variation in the reporting of service satisfaction based on the interplay between expectations and experience.

/pdf/the-influence-of-individual-characteristics-in-the-reporting-3xrru9tfj1.pdf

Sima Sandhu

Papers

Younger Adults' Understanding of Questions for a Service User Experience Survey. Funded/commissioned by: The Health and Social Care Information Centre

Provider and care workforce influences on quality of home care services in England

Younger adults' understanding of questions for a service user experience survey: a report to the Information Centre for Health and Social Care

The influence of individual characteristics in the reporting of home care service quality by service users

What do Older People Want? Lessons for Home Care Services