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The impact of having a carer on adult health and social care utilisation across five settings of care: A matched cohort study

Shand, J; Gomes, M; Morris, S; (2023) The impact of having a carer on adult health and social care utilisation across five settings of care: A matched cohort study. Health Policy , Article 104705. 10.1016/j.healthpol.2022.104705. (In press). Green open access

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Abstract

INTRODUCTION: An estimated 6.8 million people are (informal) carers in the UK. The economic value of annual carer contributions is an estimated .·132bn. Reliance on carers appears to be increasing. There is mixed evidence on whether carers are substitutes for formal care. This study investigated the association between having a carer and service use patterns across five care settings when compared to a matched cohort without a carer. MATERIALS AND METHODS: A matched case-control group analysis using person-level data in Barking and Dagenham (B&D), a London borough in the U.K., to assess the impact of having a carer in terms of the differences in cost-weighted utilisation relative to a matched control group. RESULTS: In 2016/17, for adult residents of B&D, having a carer (n = 1,295) was associated with 27% increased cost-weighted utilisation (mean difference of £2,662, CI £1,595, £3,729, p<0.001) compared to a matched cohort without a carer. 39% of the cost difference was social care. CONCLUSIONS: Findings suggest additional service use induced by carers may dominate any substitution effect. Having a carer may be a key element in enabling access to services. As such, there may be wider inequalities in service access for people without a carer. For an ageing society with projections suggesting there will be more people without carers in the future, these inequalities need to be addressed.

Type: Article
Title: The impact of having a carer on adult health and social care utilisation across five settings of care: A matched cohort study
Location: Ireland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.healthpol.2022.104705
Publisher version: https://doi.org/10.1016/j.healthpol.2022.104705
Language: English
Additional information: © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Care substitution, Health inequalities, Health service utilisation, Informal care
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
URI: https://discovery.ucl.ac.uk/id/eprint/10163645
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