Abstract
This paper investigates the cost-effectiveness of a pilot social care service for military veterans, a group relatively ill-served by traditional forms of social and health care. The service involved caseworkers signposting veterans, experiencing multiple difficulties, to sources of advice designed to assist with issues such as employment and training, education, debt, legal problems, and housing. Routinely generated data were collected on 202 veterans, concerning their characteristics, types of problem, and resources identified, and on a sub-set (n = 21) of these, regarding their outcomes in terms of well-being, measured by routine administration of the General Health Questionnaire. Costs, in terms of caseworkers' time commitments, were modelled across this sample of veterans. The additional costs as against the additional effects of the service, against usual care (the standard primary care response to this population), were modelled in terms of the Incremental Cost Effectiveness Ratio. There was a statistically significant reduction in symptoms after receipt of the service at an average cost of £155 per unit improvement in well-being. Analysis of uncertainty revealed a high probability of cost-effectiveness when set against a benchmark value of standard social care for adults. These findings are discussed in terms of the future priority given to the after-care of veterans, in particular regarding social care interventions, which remain under-evaluated.
Acknowledgements
This work was part of a study funded by Pennine Care NHS Foundation Trust to evaluate a combined psychological therapies and social care service for military veterans. Dr Alan Barrett, Helen Lambert and Paul Duthie at Pennine Care NHS Foundation Trust were involved in secure data transfer. We gratefully acknowledge the support of Andy Bacon, at the time Associate Director and Armed Forces Lead, NHS North West, Ann Touray, NHS North West and Claire Maguire, Strategic Lead, Military Veterans Service. The views expressed remain the responsibility of the authors alone.