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Study selection

A rapid review was conducted to identify published studies estimating the incremental costs or cost-effectiveness of long-term care interventions in four policy intervention areas:

  • Reducing dependency

  • Maximising coordination

  • New models of care

  • Unpaid carers.


Criteria for inclusion were that studies should:

  • Relate to a long-term care intervention;

  • Detail unit costs for individual resource categories (or allow for unit costs to be inferred);

  • Detail levels of resource use by treatment arm; and

  • Provide central (deterministic) cost estimates that could be replicated on the basis of reported unit costs and resource use.

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Details of studies selected for inclusion based on these criteria are below.

  • Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study). Glendinning C, Jones K, Baxter K, Rabiee P, Curtis L, Wilde A, Arksey H, Forder J (2010)"
    Examines the cost-effectiveness of home care reablement services in England. Home care reablement is a short-term intervention usually commissioned by local authorities. Targeted towards those recovering from illness or discharged from hospital, the service helping users to regain skills and aims to reduce the need for longer-term support. Bootstrapped estimates (using EQ-5D scores) suggested a 99% probability of the intervention being cost-effective given a £30,000 willingness-to-pay threshold, taking into account all health and social care costs. www.york.ac.uk/inst/spru/research/pdf/Reablement.pdf
  • Economic analysis of an early discharge rehabilitation service for older people. Miller P, Gladman J, Cunliffe A, Husbands S, Dewey M, Harwood R (2005)"
    Measures the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in England. The trial recruited patients aged 65 and who were fit for discharge and had needs that could be met at home without 24-hour care. Patients in the intervention arm received an EDRS home care and rehabilitation package for four weeks, while those in the usual care group were discharged to routine home care and outpatient rehabilitation. Costs for EDRS were estimated at £8,361 at 12 months, compared to £10,088 for usual care, with a high probability of cost-effectiveness using EQ-5D-based QALY scores. https://academic.oup.com/ageing/article/34/3/274/40202
  • Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study). Glendinning C, Jones K, Baxter K, Rabiee P, Curtis L, Wilde A, Arksey H, Forder J (2010)"
    Examines the cost-effectiveness of home care reablement services in England. Home care reablement is a short-term intervention usually commissioned by local authorities. Targeted towards those recovering from illness or discharged from hospital, the service helping users to regain skills and aims to reduce the need for longer-term support. Bootstrapped estimates (using EQ-5D scores) suggested a 99% probability of the intervention being cost-effective given a £30,000 willingness-to-pay threshold, taking into account all health and social care costs. www.york.ac.uk/inst/spru/research/pdf/Reablement.pdf
  • Economic analysis of an early discharge rehabilitation service for older people. Miller P, Gladman J, Cunliffe A, Husbands S, Dewey M, Harwood R (2005)"
    Measures the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in England. The trial recruited patients aged 65 and who were fit for discharge and had needs that could be met at home without 24-hour care. Patients in the intervention arm received an EDRS home care and rehabilitation package for four weeks, while those in the usual care group were discharged to routine home care and outpatient rehabilitation. Costs for EDRS were estimated at £8,361 at 12 months, compared to £10,088 for usual care, with a high probability of cost-effectiveness using EQ-5D-based QALY scores. https://academic.oup.com/ageing/article/34/3/274/40202
  • Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study). Glendinning C, Jones K, Baxter K, Rabiee P, Curtis L, Wilde A, Arksey H, Forder J (2010)"
    Examines the cost-effectiveness of home care reablement services in England. Home care reablement is a short-term intervention usually commissioned by local authorities. Targeted towards those recovering from illness or discharged from hospital, the service helping users to regain skills and aims to reduce the need for longer-term support. Bootstrapped estimates (using EQ-5D scores) suggested a 99% probability of the intervention being cost-effective given a £30,000 willingness-to-pay threshold, taking into account all health and social care costs. www.york.ac.uk/inst/spru/research/pdf/Reablement.pdf
  • Economic analysis of an early discharge rehabilitation service for older people. Miller P, Gladman J, Cunliffe A, Husbands S, Dewey M, Harwood R (2005)"
    Measures the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in England. The trial recruited patients aged 65 and who were fit for discharge and had needs that could be met at home without 24-hour care. Patients in the intervention arm received an EDRS home care and rehabilitation package for four weeks, while those in the usual care group were discharged to routine home care and outpatient rehabilitation. Costs for EDRS were estimated at £8,361 at 12 months, compared to £10,088 for usual care, with a high probability of cost-effectiveness using EQ-5D-based QALY scores. https://academic.oup.com/ageing/article/34/3/274/40202
  • Home Care Re-ablement Services: Investigating the longer-term impacts (prospective longitudinal study). Glendinning C, Jones K, Baxter K, Rabiee P, Curtis L, Wilde A, Arksey H, Forder J (2010)"
    Examines the cost-effectiveness of home care reablement services in England. Home care reablement is a short-term intervention usually commissioned by local authorities. Targeted towards those recovering from illness or discharged from hospital, the service helping users to regain skills and aims to reduce the need for longer-term support. Bootstrapped estimates (using EQ-5D scores) suggested a 99% probability of the intervention being cost-effective given a £30,000 willingness-to-pay threshold, taking into account all health and social care costs. www.york.ac.uk/inst/spru/research/pdf/Reablement.pdf
  • Economic analysis of an early discharge rehabilitation service for older people. Miller P, Gladman J, Cunliffe A, Husbands S, Dewey M, Harwood R (2005)"
    Measures the cost-effectiveness of an early discharge and rehabilitation service (EDRS) in England. The trial recruited patients aged 65 and who were fit for discharge and had needs that could be met at home without 24-hour care. Patients in the intervention arm received an EDRS home care and rehabilitation package for four weeks, while those in the usual care group were discharged to routine home care and outpatient rehabilitation. Costs for EDRS were estimated at £8,361 at 12 months, compared to £10,088 for usual care, with a high probability of cost-effectiveness using EQ-5D-based QALY scores. https://academic.oup.com/ageing/article/34/3/274/40202
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