Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: Revenue costs

Felce, David John; Mansell, Jim; Kushlick, Albert

doi:10.1016/0146-6402(80)90011-9

Cited by 9 publications

(8 citation statements)

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“…For example, Felce and Emerson (2005) summarized UK research. Early studies showed that the costs of 25-person residential facilities and six-to eight-person group homes tended to be more expensive than equivalent large institutions, albeit only slightly so when resident characteristics and occupancy levels were taken into account (Davies, Felce, Lowe, & de Paiva, 1991;Felce, 1986;Felce, Mansell, & Kushlick, 1980). However, cost assessment in these studies was not comprehensive.…”

Section: Deinstitutionalization: Outcomes and Costsmentioning

confidence: 99%

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Felce

2016

Policy Practice Intel Disabi

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The requirements for a rigorous cost‐effectiveness analysis are considered. The evidence base on services for people with ID is then reviewed with an emphasis on the transition from institutional services to those in the community and postdeinstitutionalization research on the costs and outcomes of different forms of community provision. Despite certain limitations, a number of conclusions are possible: (a) overall, community services provide for a better quality of life than institutional care; (b) whether community service costs are more or less than institutional costs may depend on factors such as funding mechanisms, wage rates and the level of investment in institutional services prior to deinstitutionalization, that are likely to differ between countries; (c) economies of scale are not pervasive but may arise among settings with very small group sizes depending on staffing model; (d) the costs of staffing are a major element in total service package costs and there is scope to relate staff input more precisely to the needs and characteristics of service users; (e) the factors responsible for variation in costs and outcomes are incompletely understood; (f) however, resource input does not appear to result in enhanced outcome; (g) greater staff input is inefficiently translated into performance which affects service users; and therefore, (h) operational culture and staff training and management are important determinants of ultimate outcome. More research is required on the factors that drive costs on the one hand and outcomes on the other. An international consensus is required on the important variables to be described when doing research on residential support arrangements, so that relationships between environmental characteristics and either costs or outcome can be identified with greater confidence.

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Section: Deinstitutionalization: Outcomes and Costsmentioning

confidence: 99%

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Felce

2016

Policy Practice Intel Disabi

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“…This inverse relationship between dependency and staffing level is common (e.g. Felce et al. 1980 , Felce 1986).…”

Section: Discussionmentioning

confidence: 99%

“…The preference for this style of living in the United Kingdom was, at least partially, due to a number of pilot projects which had demonstrated the superiority of small scale community settings over large scale segregated settings on outcome measures such as community contact, social interaction, personal development and engagement in activity (e.g. Felce et al . 1980 , Lowe & de Paiva 1991).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of staffed community housing services for people with learning disabilities: a stratified random sample of statutory, voluntary and private agency provision

Perry

Lowe

Felce

et al. 2000

Health &Amp; Social Care in the Community

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Within the staffed housing model relatively little is known about the characteristics of different types of provider agency. Data on size, homeliness and physical integration of settings, organisational culture, working methods, staffing levels and resident characteristics, were collected on a stratified random sample of provision in South-West England and Wales. Provider agencies did not differ significantly on three of the four variables relating to residents' characteristics. Nor did they differ in terms of the homeliness or physical integration of settings. However, there were significant differences between providers on the important variables of working methods and staffing levels. Resident ability correlated with staffing levels and organisational culture, but not with staff working methods. The results and their implications are discussed in the context of other research which has used the same measures.

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“…The main reason for this variation was found to be staffing costs. Felce et al (1980) found that the revenue costs of caring for children with a severe learning difficulty in community units (24 places) were similar to the costs of hospital care. Shiell and Wright (1988a) compared the costs of caring for such children in small units with a 23bedded community unit.…”

Section: Introductionmentioning

confidence: 91%

Caring for People with Learning Difficulties in Scotland: Comparative Costs

Ryan

1994

Brit J Learn Disabil

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This paper compares the costs of alternative forms of residential care for people with a learning difficulty in Scotland. The results suggest that whilst it costs less to care for adults with a severe and profound learning difficulty in hospital, it is cheaper to care for adults with a moderate or mild learning difficulty in the community. Evidence of economies of scale was found in providing care for these latter two groups in the community. Foster care placements were the cheapest form of care for children with a severe and profound learning difficulty. Other research has shown that community based small homes provide a superior quality of care.

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Evaluation of alternative residential facilities for the severely mentally handicapped in Wessex: Revenue costs

Cited by 9 publications

References 0 publications

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Community Living for Adults with Intellectual Disabilities: Unravelling the Cost Effectiveness Discourse

Characteristics of staffed community housing services for people with learning disabilities: a stratified random sample of statutory, voluntary and private agency provision

Caring for People with Learning Difficulties in Scotland: Comparative Costs

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