A modelling approach to the development of health and social services for dementia care

The United Kingdom population is aging and it is important to decide the approach to be taken to the management of dementia. Using estimated costs of pound 150 a week for home care and pound 350 a week for institutional care, a spreadsheet model was used to test three scenarios for a catchment area with 10.000 elderly people with a prevalence ratio of 0.054 dementia, i.e., 540 dementia sufferers with an average duration of survival after diagnosis of three years, i.e., an incidence of 180 new cases a year. Assuming a 20 % improvement in the balance of home to institutional care (outset parameters 40 % home care, 60 % community care) for the needs based model and a 10 % reduction in demand in the investigatory model, both models yielded similar annual costs and outperformed the historic approach, yielding savings on an annual 7.5 million pound budget of pound 450.000. Sensitivity analysis indicated that increased costs of investigation must be outweighed by decreases in the total number of dementia sufferers and estimated these decreases. Although problems are inherent within the model, the research shows the potential of taking a decision support approach to the planning of dementia care.