Cognitive disability and direct care costs for elderly people

BACKGROUND: Population ageing and the high costs of care support for elderly people have concentrated attention on economic issues. Is there an association between costs and cognitive disability? AIMS: To compare service utilisation and direct costs for elderly people with different degrees of cognitive disability, and between people living in households and in communal establishments. METHOD: Secondary analysis of Office of Population Censuses and Surveys (OPCS) Disability Surveys data compared service utilisation and costs for 8736 elderly people with cognitive disability. Cost estimates were constructed for all health and social care services. RESULTS: A much greater proportion of people at higher levels of cognitive disability lived in communal establishments, where their (direct) costs were much higher than when supported in households. Service utilisation patterns and costs varied with cognitive disability. CONCLUSIONS: It is important to look at the full range of living arrangements and support services when examining costs. The potential cost implications of pharmacotherapies, other treatments or new care arrangements cannot be appreciated without such a broad perspective.