Longo, Francesco orcid.org/0000-0002-1833-7328, Claxton, Karl orcid.org/0000-0003-2002-4694, Lomas, James orcid.org/0000-0002-2478-7018 et al. (1 more author) (2023) Is extending eligibility for adult social care better than investing more in existing users in England?:A cross-sectional evidence for multiple financial years. BMJ Open. e070833. ISSN 2044-6055
Abstract
OBJECTIVES: Publicly funded adult social care (ASC) in England aims to improve quality of life through the provision of services for individuals with care needs due to physical and/or mental impairment or illness. Access to these services, however, is often restricted to contain public expenditure. With a fast-growing care need, information on whether extending eligibility is good value for money becomes policy-relevant. PRIMARY AND SECONDARY OUTCOME MEASURES: This study investigates the effect of extending ASC eligibility on user care-related quality of life (CRQoL), a policy-relevant measure of quality of life. DESIGN: We use English cross-sectional survey data from 2017/2018 to 2019/2020 on users receiving publicly funded long-term support including domiciliary and other community-based social care, as well as residential and nursing care from local authorities responsible for ASC. We employ the two-stage least square method to estimate the impact of ASC expenditure on CRQoL at various levels of ASC expenditure in each financial year. This includes the CRQoL effect of increasing expenditure from zero to some level, which captures the effect of extending ASC eligibility to new users. RESULTS: We find that publicly funded ASC improves the CRQoL of both existing and newly eligible users, although the latter are likely to experience greater CRQoL gains. Moreover, from 2017/2018 to 2019/2020, spending as much as an average user for a newly eligible user costs between £54 224 and £77 778 per social care-quality-adjusted life year (SC-QALY) gained. These results are statistically significant at the 5% level. Compared with this finding, increasing expenditure for an existing user has always a higher cost per SC-QALY gained. CONCLUSIONS: Extending ASC eligibility to new users is likely to be more cost-effective compared with using the same resources to increase expenditure for existing users.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2023. |
Keywords: | Humans,Adult,Cross-Sectional Studies,Quality of Life,England,Eligibility Determination,Social Support |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York) |
Depositing User: | Pure (York) |
Date Deposited: | 04 Aug 2023 10:50 |
Last Modified: | 21 Jan 2025 18:09 |
Published Version: | https://doi.org/10.1136/bmjopen-2022-070833 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1136/bmjopen-2022-070833 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202107 |
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Filename: e070833.full.pdf
Description: Is extending eligibility for adult social care better than investing more in existing users in England? A crosssectional evidence for multiple financial years
Licence: CC-BY-NC 2.5