KNAPP Martin, et al
This study provides economic evidence to support the case for investing in effective, recovery-focused services for people with schizophrenia and psychosis. Drawing on a wide range of data, it sets out the evidence for the cost-effectiveness for a range of interventions and service. Those discussed are: Early Detection (ED) services; Early Intervention (EI) teams; Individual Placement and Support (IPS); Family therapy; Criminal justice liaison and diversion; Physical health promotion, including health behaviours; Supported housing; Crisis Resolution and Home Treatment (CRHT) teams; Crisis houses; Peer support; Self-management; Cognitive Behavioural Therapy (CBT); Anti-stigma and discrimination campaigns; Personal Budgets (PBs); and Welfare advice. For each intervention the report provides information on the context, the nature of the intervention, the evidence on effectiveness and cost-effectiveness, and the policy and practice implications. The report finds evidence to suggest that all of the interventions contribute to recovery outcomes, reduced costs and/or better value for money. Examples of the savings incurred through particular interventions are also included. The study was undertaken by a team from the Personal Social Services Research Unit (PSSRU), at the London School of Economics and Political Science (LSE), the Centre for Mental Health, and the Centre for the Economics of Mental and Physical Health (CEMPH) at King’s College London.
SAMPSON Christopher, et al
Introduction: Occupational therapy interventions, such as home visits, have been identified as being resource-intensive, but cost-effectiveness analyses are rarely, if ever, carried out. The authors sought to estimate the cost-effectiveness of occupational therapy home visits after stroke, as part of a feasibility study, and to demonstrate the value and methods of economic evaluation.
Method: The authors completed a cost-effectiveness analysis of pre-discharge occupational therapy home visits after stroke compared with a hospital-based interview, carried out alongside a feasibility randomised controlled trial. Their primary outcome was quality-adjusted life years. Full cost and outcome data were available for 65 trial participants.
Findings: The mean total cost of a home visit was found to be £183, compared with £75 for a hospital interview. Home visits are shown to be slightly more effective, resulting in a cost per quality-adjusted life year of just over £20,000.
Conclusion: The author's analysis is the only economic evaluation of this intervention to date. Home visits are shown to be more expensive and more effective than a hospital-based interview, but the results are subject to a high level of uncertainty and should be treated as such. Further economic evaluations in this field are encouraged.
This study estimates the economic benefits to commissioners of both health and social care across six British Red Cross schemes, two covering A&E hospital schemes, and four focused on community and individual resilience. Based on analysing these six schemes, BRC is found to be delivering substantial savings to health and social care commissioners, ranging from £168 to £704 per user relating to a rate of return between 40 to 280 per cent. Savings are realised through the prevention of hospital admission or reduced length of stay in hospital; reduced levels of hospital readmission; and preventing or minimising the use of expensive domiciliary and residential care. All the BRC schemes across the UK are estimated to have the potential to save commissioners £8m. This saving implies an overall return of 149 per cent on commissioner expenditure, suggesting that these schemes deliver material benefits and form a crucial element of care in the UK. In addition to savings there are a number of further benefits the schemes deliver, including service user benefits, signposting and assistance with access to additional services, reduction of social isolation and greater independence and wellbeing through the use of volunteers.