Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .
Occupational therapy compared with social work assessment for older people. An economic evaluation alongside the CAMELOT randomised controlled trial.
OBJECTIVES To compare costs and outcome of occupational therapy-led assessment with social worker-led assessment of older people , in terms of their independence and quality of life . DESIGN Cost-effectiveness analysis alongside a r and omised controlled trial . The analysis took viewpoints of health services and patients . The primary outcome measure for cost-effectiveness was dependency using the Community Dependency Index ( CDI ) . Secondary outcomes included utility scores based on the EuroQoL ( EQ-5D ) . Re source use was measured for each patient , from clinical records and from patient carer interviews at 8 months . Unit costs of health and social care re sources were derived from local sources and national data sets . Cost-effectiveness was analysed using cost-effectiveness acceptability curves . RESULTS There were no differences between the two arms of the trial in terms of cost-effectiveness . There is an apparent increase in mean cost per case for the occupational therapy arm but this is not statistically significant ( mean difference in cost per case 542 pounds , 95 % CI 434 - 1,519 pounds ) . Mean total costs of care per participant were 4,379 pounds and 3,837 pounds for the occupational therapy and social work arms , respectively . At best the intervention would improve outcomes at a cost of 14,000 pounds per quality -adjusted life year ( QALY ) . The probability of such an outcome was < 50 % . CONCLUSIONS From a policy perspective , the lack of difference in clinical and cost-effectiveness means that either a social work or an occupational therapy service is successful in making care assessment s that enable an older person to remain in their own home
Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .