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Improving the mix of institutional and community care for older people with dementia : an application of the balance of care approach in eight European countries

Tucker, S.; Sutcliffe, C.; Bowns, I.; Challis, D.; Saks, K.; Verbeek, H.; Cabrera, E.; Karlsson, S. LU ; Leino-Kilpi, H. and Meyer, G., et al. (2016) In Aging and Mental Health 20(12). p.1327-1338
Abstract

Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach. Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives. Results:... (More)

Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach. Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives. Results: The findings suggest a noteworthy minority of ILTC entrants could be more appropriately supported in the community if enhanced services were available. This would not necessarily require innovative services, but more standard care (including personal and day care), assuming quality was ensured. Potential cost savings were identified in all countries, but community care was not always cheaper than ILTC and the ability to release resources varied between nations. Conclusions: This is believed to be the first transnational application of the BoC approach, and demonstrates its potential to provide a consistent approach to planning across different health and social care systems. Better comparative information is needed on the number of ILTC entrants with dementia, unit costs and outcomes. Nevertheless, the findings offer important evidence on the appropriateness of current provision, and the opportunity to learn from different countries' experience.

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publication status
published
subject
keywords
balance of care, dementia, home care, institutionalisation, resource allocation
in
Aging and Mental Health
volume
20
issue
12
pages
12 pages
publisher
Carfax Publishing
external identifiers
  • scopus:84940529706
  • wos:000386791000011
ISSN
1360-7863
DOI
10.1080/13607863.2015.1078285
language
English
LU publication?
yes
id
ce776e97-2690-4a05-9420-5591923dce89
date added to LUP
2016-11-04 10:07:31
date last changed
2017-09-14 14:25:04
@article{ce776e97-2690-4a05-9420-5591923dce89,
  abstract     = {<p>Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach. Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives. Results: The findings suggest a noteworthy minority of ILTC entrants could be more appropriately supported in the community if enhanced services were available. This would not necessarily require innovative services, but more standard care (including personal and day care), assuming quality was ensured. Potential cost savings were identified in all countries, but community care was not always cheaper than ILTC and the ability to release resources varied between nations. Conclusions: This is believed to be the first transnational application of the BoC approach, and demonstrates its potential to provide a consistent approach to planning across different health and social care systems. Better comparative information is needed on the number of ILTC entrants with dementia, unit costs and outcomes. Nevertheless, the findings offer important evidence on the appropriateness of current provision, and the opportunity to learn from different countries' experience.</p>},
  author       = {Tucker, S. and Sutcliffe, C. and Bowns, I. and Challis, D. and Saks, K. and Verbeek, H. and Cabrera, E. and Karlsson, S. and Leino-Kilpi, H. and Meyer, G. and Soto, M. E. and Stephan, Astrid and Renom-Guiteras, Anna and Sauerland, Dirk and Wüubker, Ansgar and Bremer, Patrick and Hamers, Jan P H and Afram, Basema and Beerens, Hanneke C. and Bleijlevens, Michel H C and Zwakhalen, Sandra M G and Ruwaard, Dirk and Ambergen, Ton and Rahm Hallberg, Ingalill and Melin Emilsson, Ulla and Lethin, Connie and Jolley, David and Roe, Brenda and Burns, Alistair and Koskenniemi, Jaana and Suhonen, Riitta and Viitanen, Matti and Arve, Seija and Stolt, Minna and Hupli, Maija and Tiit, Ene Margit and Leibur, Jelena and Raamat, Katrin and Armolik, Angelika and Marjatta Toivari, Teija Tuula and Zabalegui, Adelaida and Risco, Ester and Alvira, Carme and Farre, Marta and Miguel, Susana and Milhet, Agathe and Sourdet, Sandrine and Gillette, Sophie and Vellas, Bruno and , },
  issn         = {1360-7863},
  keyword      = {balance of care,dementia,home care,institutionalisation,resource allocation},
  language     = {eng},
  month        = {12},
  number       = {12},
  pages        = {1327--1338},
  publisher    = {Carfax Publishing},
  series       = {Aging and Mental Health},
  title        = {Improving the mix of institutional and community care for older people with dementia : an application of the balance of care approach in eight European countries},
  url          = {http://dx.doi.org/10.1080/13607863.2015.1078285},
  volume       = {20},
  year         = {2016},
}