Elderly People with Advanced Cognitive Impairment in England: Resource Use and Costs

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Abstract
This paper describes where elderly people with moderate to severe (‘advanced’) cognitive impairment are living, what resources they use and the costs of these services to different funding agencies. It operationally defines dementia in terms of cognitive impairment and uses the OPCS disability surveys to estimate the prevalence of moderate to severe cognitive impairment in England. The paper goes on to describe services received by this client group on the basis of the same surveys, and costs these by supplementing the data with information from related studies by the PSSRU. Since accommodation is a major cost, the population of elderly people with cognitive impairment is classified according to their place of residence. Thus we are able to estimate the ‘baseline’ global cost of provision for this client group at current prices. We make cost projections at 1991/92 price levels to the national level, and discuss the implications in terms of burdens to different agencies.