Costs of formal care for frail older people in England: the resource implications study of the MRC cognitive function and ageing study (RIS MRC CFAS)

The aim of this paper is to quantify service use and costs of supporting fr ail older people at home in the community, using data collected in a longit udinal multicentre stratified randomised study for 1055 mentally frail, phy sically frail, and mentally and physically frail subjects. Average costs pe r person per week were found to total pound 64.45, with a small number of s ervices accounting for a large proportion of the total costs. The level of services offered by the nonstatutory voluntary and private sectors was foun d to be small. To highlight issues for policy makers, the extent of cost va riations between a number of different subgroups were calculated. These biv ariate analyses revealed substantial variation in costs, especially accordi ng to household structure, type of frailty, whether admission to continuing care accommodation occurred and survival. Multiple regression analysis dem onstrated that 26% of the variation in log average weekly costs could be ex plained by a number of socio-demographic and health status variables. A par ticularly close relationship was observed between costs and whether admissi on to continuing care accommodation occurred, highlighting a need for polic y-makers to examine the nature and scale of provision of alternative commun ity based care packages. The results demonstrate that descriptive cost data such as those presented carl provide information useful to the planning pr ocess, enabling more informed choices to be made over the provision of serv ices for particular groups of people. (C) 1998 Elsevier Science Ltd. All ri ghts reserved.