A Matched Comparison Study of Cost-Effectiveness: Institutionalized and Deinstitutionalized People

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Abstract
Seventy people with mental retardation who had moved from a large state institution to small community living arrangements were matched with 70 people who remained at the same institution. They were matched by sex, level of retardation, years institutionalized, self-care skills, age, and IQ. Developmental growth, operationally defined as adaptive behavior change using a research version of the AAMD Adaptive Behavior Scale, was measured for all people; only those people who had been deinstitutionalized demonstrated significant growth. They also received more services. Subsequently, telephone surveys and other procedures were used to identify the inclusive public costs associated with the two groups. Upon comparison, the deinstitutionalized group required less public money than the institutionalized group, although the financial burden shifted substantially from federal sources to state (and local) funding sources when people moved from the institution to community-based facilities. Correlates of costs in the community were explored in a preliminary way.

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