Powell J E, Langley C, Kirwan J, Gubbay D, Memel D, Pollock J, Means R, Hewlett S
Faculty of Health and Social Care, University of the West of England, Bristol, Glenside Campus, Blackberry Hill, Stapleton, Bristol BS16 1DD, UK.
Rheumatology (Oxford). 2004 Sep;43(9):1167-72. doi: 10.1093/rheumatology/keh278. Epub 2004 Jun 22.
To quantify the set-up costs and monetary benefits of a welfare rights service integrated within an NHS service provider, that selects eligible patients using the Health Assessment Questionnaire (HAQ) and offers welfare rights advice to assist in application for Disability Living Allowance and Attendance Allowance.
(1) DESIGN: a cost evaluation of a social intervention, screening with the HAQ and welfare rights advice in primary care and hospital settings. (2) SETTING: Eight general practices and four hospital rheumatology out-patient departments were selected from four localities in the southwest of England. (3) PARTICIPANTS: Two hundred and sixty-eight eligible patients with arthritis accepted an interview with a welfare rights officer (WRO) from a sample of 1989 service users identified from GPs' records and hospital out-patient lists. Two hundred and forty two service users expressed an interest in take up of the social intervention. (4) Service users with a HAQ score >/=1.5 were contacted by telephone and offered an appointment with an experienced WRO to help them complete a welfare benefit application form. A 'micro-costing' study was undertaken with assessment of monetary benefits received.
The indicative set-up costs of similar welfare rights services are pound 8125 in a GP setting and pound 9307 per annum in a hospital setting at 2002 prices. Total annual unclaimed Disability Living Allowance/Attendance Allowance granted to successful claimants was pound 184,382 in the GP setting (n = 84 from 137) and pound 169,309 in the hospital setting (n = 79 from 131).
Welfare rights advice received during a visit to a GP practice or a hospital out-patient department can substantially reduce the level of unclaimed benefit in arthritic populations including the elderly; with mobility and care difficulties. A welfare rights service integrated within a GP practice or hospital that screens people with arthritis using HAQ scores and encourages those with scores >/=1.5 to see a WRO for help with welfare benefit confers monetary benefits for service users that substantially outweigh set-up costs.
量化整合于国民健康服务（NHS）服务提供商内的福利权益服务的设立成本和货币收益。该服务使用健康评估问卷（HAQ）筛选符合条件的患者，并提供福利权益建议，以协助申请残疾生活津贴和护理津贴。
（1）设计：一项社会干预的成本评估，在初级保健和医院环境中使用HAQ进行筛查并提供福利权益建议。（2）设置：从英格兰西南部的四个地区选取了8家全科诊所和4家医院的风湿病门诊部门。（3）参与者：从全科医生记录和医院门诊名单中确定的1989名服务使用者样本中，268名符合条件的关节炎患者接受了福利权益官员（WRO）的访谈。242名服务使用者表示有兴趣接受社会干预。（4）对HAQ评分≥1.5的服务使用者进行电话联系，并安排与经验丰富的WRO预约，以帮助他们填写福利津贴申请表。进行了一项“微观成本核算”研究，评估获得的货币收益。
以2002年的价格计算，类似福利权益服务在全科诊所环境中的指示性设立成本为8125英镑，在医院环境中为每年9307英镑。成功申请者获得的年度未申领残疾生活津贴/护理津贴总额在全科诊所环境中为184382英镑（137人中84人），在医院环境中为169309英镑（131人中79人）。
在全科诊所或医院门诊就诊期间获得的福利权益建议可大幅降低关节炎患者群体（包括老年人，存在行动和护理困难）未申领福利的水平。整合于全科诊所或医院内的福利权益服务，使用HAQ评分筛选关节炎患者，并鼓励评分≥1.5的患者寻求WRO帮助申请福利津贴，为服务使用者带来的货币收益大大超过设立成本。
