Start Methods of accommodating diversity in aged care

Methods of accommodating diversity in aged care

In sensitivity analyses, telehealth costs remained slightly (non-significantly) higher than usual care costs, even after assuming that equipment prices fell by 80% or telehealth services operated at maximum capacity.

Patients in the intervention group received telehealth in addition to the standard health or social care services available in their area.20The WSD telehealth questionnaire study was nested within the parent trial described above.

The questionnaire study used participant reported outcomes collected from a subset (n=1573) of the parent trial sample and served as the basis for evaluating acceptability, effectiveness, and cost effectiveness of telehealth as a supplement to standard care.18 20 Patients who had cognitive impairments that would impair their ability to independently complete evaluation instruments were not eligible for the questionnaire study, although they were eligible for the parent trial, because data for outcome measures were to be collected first hand.20 All eligible patients were asked during the assessment visit by the WSD project team whether they would be willing to participate in the questionnaire study in addition to the main trial.

Baseline interviews were arranged with those trial participants who agreed, and recruitment into the questionnaire study continued with the aim of reaching the 550 participants for each index condition (or 1650 in total).20At baseline, patients agreeing to participate were visited by trained interviewers18 who obtained additional informed written consent for the questionnaire study, and collected information on primary and secondary outcomes.

Data for service use were also collected using the Client Services Receipt Inventory.21 This instrument collects comprehensive information on patient service use, living arrangements, and employment status as well as patterns of unpaid care and support by their family or other carers.

We compared the costs and cost effectiveness of telehealth services (as an addition to standard support and treatment) with those of standard support and treatment alone.

This analysis was part of the Whole System Demonstrator (WSD) programme, funded by the Department of Health.7 17A pragmatic, cluster randomised controlled trial (the WSD telehealth trial) used routinely collected administrative datasets to examine the effect of telehealth on primary and secondary healthcare and social care use by individuals with long term conditions (chronic obstructive pulmonary disease, heart failure, or diabetes) in three demographically diverse sites.18 The WSD sites (local authority areas in England) were chosen for having an established record of joint working between health and social care; they were covered by four primary care trusts.

Patients who consented to sharing health and social care data with the research team were visited by the local WSD project team to confirm the patient’s eligibility and check the suitability of the patient’s home for telehealth.