This evidence theme is a summary of one of the key topics identified by a scoping review of rehabilitation, reablement, and restorative care research. If you need more information on this topic, try using the PubMed search below.
We found ten reviews on economic evaluations of rehabilitation, reablement, and restorative care interventions in aged care. Comparative economic cost analyses in rehabilitation showed that:
- The cost of prompted voiding plus exercise program was four times higher than usual care as it required additional staff to deliver the service. [3, 4] However, these findings were reported in 2005 and would not reflect current costs.
- Exergames used to promote exercise can be integrated into falls prevention programs at a low cost. Exergames are cost-effective in improving the strength and balance of older people in residential aged care facilities. [5,6]
- Functional Incidental Training (FIT) targeted at specific individual needs such as standing up and toileting, was no more expensive than usual care. [7,8]
Reviews comparing the cost-effectiveness of reablement and restorative care interventions found that:
- The costs associated with a Home Independence Program (HIP) were lower than usual home care. This equated to a median cost saving of AU$12,500 across five years. [9-12] The HIP program included home visits, training in the activities of daily living, task redesign, exercise, and different types of self-care activities with ongoing personal care reflecting the goals of the client.
- The costs of rehabilitation directed by occupational therapists (OT) and physiotherapists were lower than usual care. [13]
- Both the HIP and therapist-driven interventions reduced the costs of home care services and personal care costs. They also lowered the risk of emergency department visits and hospital costs.
- The mean cost of reablement services for maintaining functional independence was lower than usual care. [14,15] However, this finding was based on one study demonstrating low methodological quality. [15]
- Occupational therapy in social services reablement programs involving housing adaptations and equipment prescription is potentially cost-effective. These services often enable older people to live in their own homes longer. However, it was not possible to determine the cost-saving contribution of the OT component which was reported as part of overall rehabilitation and reablement social services cost-effectiveness. [16]
- Enhanced home care interventions involving nursing care, falls prevention, interdisciplinary care coordination, telemedicine, and restorative care or reablement showed varying levels of cost-effectiveness compared with usual care. [17]
- Alternative nursing care focused on health promotion and preventive care had positive cost-effectiveness and impact on health-related quality of life. However, it showed inconsistent results for function, use of health services, mood, and mental health. [17]
- Interdisciplinary care coordination in the form of integrated home and discharge planning may be cost-effective.
- Telemedicine or remote monitoring had inconsistent cost-effectiveness impact on function, use of health services and physical health.
- Restorative care and reablement services were cost-effective for function and use of health services. By modifying their strategies, rehabilitation professionals such as OTs or physiotherapists who are already providing home care services might further reduce these costs.
