Kavanagh S, Knapp M
London School of Economics.
Br J Psychiatry. 1999 Jun;174:539-46. doi: 10.1192/bjp.174.6.539.
Population ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Is there an association between costs and cognitive disability?
To compare service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments.
Secondary analysis of Office of Population Censuses and Surveys (OPCS) Disability Surveys data compared service utilisation and costs for 8736 elderly people with cognitive disability. Cost estimates were constructed for all health and social care services.
A much greater proportion of people at higher levels of cognitive disability lived in communal establishments, where their (direct) costs were much higher than when supported in households. Service utilisation patterns and costs varied with cognitive disability.
It is important to look at the full range of living arrangements and support services when examining costs. The potential cost implications of pharmacotherapies, other treatments or new care arrangements cannot be appreciated without such a broad perspective.
人口老龄化以及老年人护理支持的高昂成本已使人们将注意力集中在经济问题上。成本与认知障碍之间是否存在关联？
比较不同认知障碍程度的老年人以及居住在家庭和社区机构中的老年人的服务利用情况和直接成本。
对人口普查与调查办公室（OPCS）残疾调查数据进行二次分析，比较了8736名有认知障碍的老年人的服务利用情况和成本。对所有医疗和社会护理服务进行了成本估算。
认知障碍程度较高的人群中，居住在社区机构的比例要大得多，他们在社区机构的（直接）成本远高于在家庭中得到支持时的成本。服务利用模式和成本因认知障碍而异。
在研究成本时，审视全面的生活安排和支持服务很重要。如果没有如此广阔的视角，就无法认识到药物治疗、其他治疗或新的护理安排可能产生的成本影响。
