Economic evidence in intellectual disabilities: a review

Romeo, Renée; Molosankwe, Iris

doi:10.1097/yco.0b013e32833ad946

Cited by 15 publications

(17 citation statements)

References 19 publications

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“…The authors concluded that there was no evidence of relative cost-effectiveness for either individual budgets or standard arrangements. If policy is to aspire to being evidence-based, there is an on-going requirement for rigorous cost-effectiveness research, a conclusion also reached by Romeo and Molosankwe (2010).…”

Section: Discussionmentioning

confidence: 99%

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Felce

2016

Policy Practice Intel Disabi

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The requirements for a rigorous cost‐effectiveness analysis are considered. The evidence base on services for people with ID is then reviewed with an emphasis on the transition from institutional services to those in the community and postdeinstitutionalization research on the costs and outcomes of different forms of community provision. Despite certain limitations, a number of conclusions are possible: (a) overall, community services provide for a better quality of life than institutional care; (b) whether community service costs are more or less than institutional costs may depend on factors such as funding mechanisms, wage rates and the level of investment in institutional services prior to deinstitutionalization, that are likely to differ between countries; (c) economies of scale are not pervasive but may arise among settings with very small group sizes depending on staffing model; (d) the costs of staffing are a major element in total service package costs and there is scope to relate staff input more precisely to the needs and characteristics of service users; (e) the factors responsible for variation in costs and outcomes are incompletely understood; (f) however, resource input does not appear to result in enhanced outcome; (g) greater staff input is inefficiently translated into performance which affects service users; and therefore, (h) operational culture and staff training and management are important determinants of ultimate outcome. More research is required on the factors that drive costs on the one hand and outcomes on the other. An international consensus is required on the important variables to be described when doing research on residential support arrangements, so that relationships between environmental characteristics and either costs or outcome can be identified with greater confidence.

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Section: Discussionmentioning

confidence: 99%

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Felce

2016

Policy Practice Intel Disabi

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“…In conclusion, the results of this study provide information on the burden caused by disabilities in rural and urban households in Central Vietnam. Such economic analyses can inform decision‐makers about additional investments that are needed to improve the welfare system (Romeo & Molosankwe ). The results have policy implications, for prioritising health problems and for adjusting welfare conditions, strengthening CBR services and government support.…”

Section: Discussionmentioning

confidence: 99%

Burden of care for persons with disabilities in Vietnam

Riewpaiboon

Minh

Hương³

et al. 2014

Health Soc Care Community

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Vietnam has more than 6 million persons with disabilities (PWD), or 7.8% of the population. To provide better services for them, it is important to investigate the care they currently receive, and to obtain evidence on the health outcomes from that care. This study aimed to estimate the quality of life and functional status of a group of PWD in Vietnam and the cost of care they receive. This was an analytical study exploring the time and cost of informal care, the cost of illness (prevalence-based, patient perspective), quality of life using EuroQoL and functional status using the Barthel Index. The sample was selected from urban and rural areas of Quang Tri province in Central Vietnam, using systematic random sampling. Data were collected by face-to-face interviews, and in a 1-month diary recorded during July-August 2010 for summer and in December 2010 for winter. The costs are presented in 2010 USD values. The data were analysed by descriptive, univariate and multivariate statistics to summarise and explore the relationships among dependent and independent variables. The study sample included 210 PWD, with an average age of 38 years and duration of disability on average 26 years. The health-related quality of life measured in terms of the health utility score (0 = death, 1 = full health) was on average 0.44 and 0.39 in summer and winter respectively. The total cost of illness per year per case was USD 971 (83% of gross domestic product per capita); explanatory variables were the age of the PWD, receiving community-based rehabilitation, receiving government support and the severity of the disability. This illustrates the importance of services and support for reduction of the economic burden on the family. In conclusion, the results of this study provide information on the burden caused by disabilities in rural and urban households in Vietnam.

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“…There are a few studies that have examined the cost of services or interventions for children with intellectual disabilities (Romeo & Molosankwe 2010). Romeo & Molosankwe (2010) found only seven studies in their review of economic evidence in intellectual disabilities which examined economic aspects of care for people with intellectual disabilities. In this article, we report on the findings of a survey of all young people with intellectual disabilities who were identified as having challenging behaviour and in transition to adult services between 2006 and 2008 in one inner London borough.…”

Section: Costs Of Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Urban adolescents with intellectual disability and challenging behaviour: costs and characteristics during transition to adult services

Barron

Molosankwe

Romeo

et al. 2013

Health &Amp; Social Care in the Community

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Young persons with intellectual disabilities and challenging behaviour in transition usually have complex needs, which may not be served well within existing resources. In this article, we present a survey of all the young people, between 16 and 18 years of age with intellectual disabilities and challenging behaviour identified in one inner London borough. They were in transition to adult services at the time of the study (between 2006 and 2008). The objective was to examine their socio-demographic and clinical characteristics, pattern of service use and associated costs of care. An assessment toolkit was devised to measure the mental and physical health, challenging behaviour and service use of the sample. Instruments within the toolkit included the Strengths and Difficulties Questionnaire, challenging behaviour scale, Client Service Receipt Inventory (CSRI) and socio-demographic data form. Twenty-seven individuals in transition to adult services had challenging behaviour, 23 of whom had mental health diagnoses and 18 of whom had physical diagnoses. Severity of challenging behaviour did not correlate with cost of care. Informal care accounted for the highest proportion of the total cost of care (66%) with education being the second largest contributor at 22%. Evidence on transition outcomes for young people with complex needs and intellectual disabilities and associated costs is lacking. This article illustrates some of the relevant issues in this area. Further research is required to investigate these aspects and guide commissioning of appropriate services.

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Economic evidence in intellectual disabilities: a review

Cited by 15 publications

References 19 publications

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Burden of care for persons with disabilities in Vietnam

Urban adolescents with intellectual disability and challenging behaviour: costs and characteristics during transition to adult services

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