Planning Care for Elderly People Using the Balance of Care Model

Abstract

Planning health and social services for client groups has become an integral part of the planning process within the United Kingdom. The Department of Health's microcomputer model--Balance of Care--attempts to analyse different policies for the care of the elderly and to assess the consequences of such policies in terms of the resources required. This paper shows how the model operates using data from a survey of elderly people in Northern Ireland. An attempt is also made to introduce economic principles into the decision making process. Attention is drawn to the economist's definition of costs and how this can differ from the public expenditure concept of costs. A further area of interest is the process of allocating people to specific types of care. The economic approach points to the need to make explicit valuations of the benefits of various services against a background of costs. Within this context, the Balance of Care model can be used to consider various scenarios and as such is a useful tool in the decision making process.

Performance Measurement in Social Care: A Comparison of Efficiency Measurement Methods

“…However, in order to rank authorities some strategy is needed, A main indicator of output reflecting the local 'balance of care' (Mooney, 1978;McCallion, 1993) assuming that older people prefer to remain at home and that this is more beneficial for their welfare (Harding, 1999) As authorities shift the balance of care away from residential to home care, overall costs should fall Percent of older people living alone (SN 130) A proxy measure of need for services (Bebbington and Davies, 1980) Authorities with a greater proportion of their older population living alone (the greatest users of social care services) will tend to incur higher costs as they will require more input from services Number of contact hours per household (AA68)…”

National trends and local delivery in old age mental health services: towards an evidence base. A mixed-methodology study of the balance of care approach, community mental health teams and specialist mental health outreach to care homes

“…10,[102][103][104] Again, however, there seems nothing to restrict the model's use to this group (as illustrated by the diversity of groups represented in Table 2), nor to a particular setting. Thus, while more than half of studies echoed the then DHSS's interest in shifts between hospital, residential and community services, [105][106][107][108] almost one-third focused simply on the residential/ domiciliary margin. 96,99,109,110 The remainder included studies of the potential to locate renal dialysis services in three alternative hospital settings 111 and divert acute psychiatric inpatients to supported hostels.…”

“…District Auditors (1981) 127 Rosenhead et al McCallion (1993) 107 Audit Inspectorate (1983) 93 Rutherford and Forte (2003) 111 DHSS (1981) 81 Forte and Bowen (1997) 100 …”

On the effectiveness of care co-ordination services aimed at preventing hospital admissions and emergency attendances

“…Although there is a history of modelling care delivered in the home (e.g. [ 2 , 11 , 15 , 16 ]), research from a preventive perspective is thin on the ground. One arguable consequence is, as Wanless [ 23 ] notes, “…progress in reducing delayed transfers from hospital, has not been matched by avoidable [i.e.…”