Table 5: Sensitivity analysis
|
Parameter |
Base case |
Low value |
High |
Dominance |
PCC cost per unit |
|
Staff time |
$27 p/h |
$17 p/h |
$37 p/h |
Yes |
PI: $6.23 - $9.79 FU: $5.00 - $7.86 |
|
Cost of post- |
$1,600 |
10 |
$3,200 |
Yes |
^N∕A |
|
Cost of post- |
$360 |
10 |
$720 |
Yes |
PI: $6.73 - $9.29 FU: $5.40 - $7.46 |
|
DCM mapping |
16 staff hours |
8 staff |
24 staff hours |
Yes |
^nta |
* PI = Post-intervention; FU = Follow-up
This evaluation is, to our knowledge, the first to investigate the relative costs of PCC
and DCM in a dementia care setting. In similar population groups, existing work has
been done in community settings for occupational therapy[15] and respite for
carers.[16] However, neither these interventions nor this population group have
received significant attention in the cost-effectiveness literature. Our results suggest
that PCC, if properly implemented, can match (and potentially exceed) the positive
outcomes achieved through the use of DCM and do so at a lower cost. This is an
important result as it provides decision makers with information which they can use to
allocate resources to other areas of dementia care and the healthcare sector as a whole,
while maximising the quality of life (and minimising the rate and level of BPSD)
experienced by residents of dementia care settings. Such considerations will become
increasingly important with the future increase in dementia prevalence.[2] There are,
however, a number of caveats which should be considered alongside this result.
Other cost issues might be significant in assessing the cost-effectiveness of PCC and
DCM. For example, it has been found that caring for people with dementia-related
behavioural problems may impact on the morale and turnover of staff.[8] If this is
true, the potentially substantial costs associated with staff turnover (both in terms of
‘flag-drop’ costs of recruitment and in the cost of DCM/PCC training) should be