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Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements

J. Perry, D. G. Allen, C. Pimm, A. Meek, K. Lowe, S. Groves, D. Cohen, D. Felce, Samantha Groves

Journal of Intellectual Disability Research, Volume: 57, Issue: 2, Pages: 139 - 152

Swansea University Author: Samantha Groves

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DOI (Published version): 10.1111/j.1365-2788.2012.01558.x

Abstract

BACKGROUND: People with severe challenging behaviour are vulnerable to exclusion from local services and removal to out-of-area placements if locally available supported accommodation is insufficient to meet their needs. There are concerns about the high costs and potentially poorer outcomes of out-...

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Published in: Journal of Intellectual Disability Research
Published: 2013
URI: https://cronfa.swan.ac.uk/Record/cronfa22178
first_indexed 2015-06-27T02:06:56Z
last_indexed 2018-02-09T05:00:24Z
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recordtype SURis
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spelling 2015-06-26T12:13:55.6188437 v2 22178 2015-06-26 Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements eb642e3823a000ee7550db9c062c2cdb Samantha Groves Samantha Groves true false 2015-06-26 BACKGROUND: People with severe challenging behaviour are vulnerable to exclusion from local services and removal to out-of-area placements if locally available supported accommodation is insufficient to meet their needs. There are concerns about the high costs and potentially poorer outcomes of out-of-area placements but relatively little is known about how costs and outcomes compare with provision for a similar population placed locally.METHODS: Costs, quality of care and a wide range of quality of life outcomes for 38 people with intellectual disabilities and challenging behaviour living in-area and 38 similar people living out-of-area were compared. The two groups were matched as far as possible on risk factors for out-of-area placement. The out-of-area group represented two-thirds of the total number of people who originated from the territory served by the largest specialist health service in Wales and were placed in residential settings at least 10 miles beyond its boundaries.RESULTS: There was a mixed pattern of quality of care and quality of outcome advantages between the two types of setting, although in-area placements had a greater number of advantages than out-of-area placements. Unexpectedly, out-of-area placements had lower total costs, accommodation costs and daytime activity costs.CONCLUSIONS: No overall conclusion could be reached about cost-effectiveness. A number of potential reasons for the differences in cost were identified. Although additional resources may be needed to provide in-area services for those currently placed out-of-area, government policy to provide comprehensively for those who want to live locally, irrespective of their needs, appears to be attainable. Journal Article Journal of Intellectual Disability Research 57 2 139 152 31 12 2013 2013-12-31 10.1111/j.1365-2788.2012.01558.x COLLEGE NANME COLLEGE CODE Swansea University 2015-06-26T12:13:55.6188437 2015-06-26T12:13:55.6188437 Faculty of Medicine, Health and Life Sciences School of Health and Social Care J. Perry 1 D. G. Allen 2 C. Pimm 3 A. Meek 4 K. Lowe 5 S. Groves 6 D. Cohen 7 D. Felce 8 Samantha Groves 9
title Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
spellingShingle Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
Samantha Groves
title_short Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
title_full Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
title_fullStr Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
title_full_unstemmed Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
title_sort Adults with intellectual disabilities and challenging behaviour: the costs and outcomes of in- and out-of-area placements
author_id_str_mv eb642e3823a000ee7550db9c062c2cdb
author_id_fullname_str_mv eb642e3823a000ee7550db9c062c2cdb_***_Samantha Groves
author Samantha Groves
author2 J. Perry
D. G. Allen
C. Pimm
A. Meek
K. Lowe
S. Groves
D. Cohen
D. Felce
Samantha Groves
format Journal article
container_title Journal of Intellectual Disability Research
container_volume 57
container_issue 2
container_start_page 139
publishDate 2013
institution Swansea University
doi_str_mv 10.1111/j.1365-2788.2012.01558.x
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
document_store_str 0
active_str 0
description BACKGROUND: People with severe challenging behaviour are vulnerable to exclusion from local services and removal to out-of-area placements if locally available supported accommodation is insufficient to meet their needs. There are concerns about the high costs and potentially poorer outcomes of out-of-area placements but relatively little is known about how costs and outcomes compare with provision for a similar population placed locally.METHODS: Costs, quality of care and a wide range of quality of life outcomes for 38 people with intellectual disabilities and challenging behaviour living in-area and 38 similar people living out-of-area were compared. The two groups were matched as far as possible on risk factors for out-of-area placement. The out-of-area group represented two-thirds of the total number of people who originated from the territory served by the largest specialist health service in Wales and were placed in residential settings at least 10 miles beyond its boundaries.RESULTS: There was a mixed pattern of quality of care and quality of outcome advantages between the two types of setting, although in-area placements had a greater number of advantages than out-of-area placements. Unexpectedly, out-of-area placements had lower total costs, accommodation costs and daytime activity costs.CONCLUSIONS: No overall conclusion could be reached about cost-effectiveness. A number of potential reasons for the differences in cost were identified. Although additional resources may be needed to provide in-area services for those currently placed out-of-area, government policy to provide comprehensively for those who want to live locally, irrespective of their needs, appears to be attainable.
published_date 2013-12-31T04:57:53Z
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score 11.096913

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