Costs of occupational therapy in residential homes and its impact on service use

Abstract

The Care Home Activity Project was a feasibility study examining the effect of occupational therapy on levels of depression and quality of life of residents in care homes. This paper describes the costs of the one year occupational therapy intervention, the use and cost of services received by the residents both before and after the intervention and compares these with the services received by a control group over the same period. Eight homes in northern England were included in the study with four homes receiving the services of a full-time occupational therapist, the remaining four acting as the control group. Services received by residents in both groups were recorded at the beginning and end of the one year study. The cost of the occupational therapy intervention was computed from published unit costs with adjustments for travel, equipment costs and methods of working. There was a significant increase in the likelihood of using social services in the intervention homes. This could be explained by previously unrecognised needs being revealed by the therapists. There may have been a reduction in health costs in the intervention group. At 2005 levels, the net cost of providing the occupational therapy service was £16 (E23) per resident per week. This study demonstrates that occupational therapy is feasible in residential homes at modest cost. It may uncover unmet needs for some services. Future studies should match groups for hospital use at baseline.

Acknowledgements

The interventions described in this paper were delivered by Aileen Cruickshank, Shaan Ellor, Ros Williamson and Rachel Lovegrove, working for the Occupational Therapy Service, Selby and York Primary Care Trust, York, UK, under the supervision of Barbara Stoker, and with professional advice from Professor Matthew Molineux, of Leeds Metropolitan University. The authors gratefully acknowledge the participation of all eight study homes, staff, residents and their relatives. The study was funded by The Health Foundation. Any views expressed are the authors’ alone.