May, Peter and Lombard-Vance, Richard
(2019)
Effect of deinstitutionalisation for adults with intellectual disabilities on costs: a systematic review.
BMJ Open, 9 (e02573).
ISSN 2044-6055
Abstract
Objective: To review systematically the evidence on the
costs and cost-effectiveness of deinstitutionalisation for
adults with intellectual disabilities.
Design: Systematic review.
Population: Adults (aged 18 years and over) with
intellectual disabilities.
Intervention: Deinstitutionalisation, that is, the move from
institutional to community settings.
Primary and secondary outcome measures: Studies
were eligible if evaluating within any cost-consequence
framework (eg, cost-effectiveness analysis, cost–utility
analysis) or resource use typically considered to fall within
the societal viewpoint (eg, cost to payers, service-users,
families and informal care costs).
Search: We searched MEDLINE, PsycINFO, CENTRAL,
CINAHL, EconLit, Embase and Scopus to September 2017
and supplemented this with grey literature searches and
handsearching of the references of the eligible studies. We
assessed study quality using the Critical Appraisals Skills
Programme suite of tools, excluding those judged to be of
poor methodological quality.
Results: Two studies were included; both were cohort
studies from the payer perspective of people leaving long-stay National Health Service hospitals in the UK between
1984 and 1992. One study found that deinstitutionalisation
reduced costs, one study found an increase in costs.
Conclusion: A wide-ranging literature review found limited
evidence on costs associated with deinstitutionalisation
for people with intellectual disabilities. From two studies
included in the review, the results were conflicting.
Significant gaps in the evidence base were observable,
particularly with respect to priority populations in
contemporary policy: older people with intellectual
disabilities and serious medical illness, and younger
people with very complex needs and challenging
behaviours.
| Item Type: |
Article
|
| Additional Information: |
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Cite as: May P, Lombard Vance R, Murphy E, et al. Effect of deinstitutionalisation for adults with intellectual disabilities on costs: a
systematic review. BMJ Open 2019;9:e025736. doi:10.1136/bmjopen-2018-025736 |
| Keywords: |
deinstitutionalisation; adults with intellectual disabilities; costs; |
| Academic Unit: |
Faculty of Science and Engineering > Psychology |
| Item ID: |
15079 |
| Identification Number: |
https://doi.org/10.1136/bmjopen-2018-025736 |
| Depositing User: |
Richard Lombard-Vance
|
| Date Deposited: |
30 Nov 2021 16:34 |
| Journal or Publication Title: |
BMJ Open |
| Publisher: |
BMJ Publishing Group |
| Refereed: |
Yes |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
Repository Staff Only(login required)
 |
Item control page |
Downloads per month over past year
Origin of downloads
Altmetric
Altmetric