At what cost? Using cost information for purchasing and providing community care for people with learning disabilities

An appreciation of costs and cost effectiveness has been central to policy initiatives, reports by the Audit Commission and the 1990 community care reforms. This paper argues the case for a more informed use of cost information in services for people with learning disabilities, using examples from research into the costs and outcomes of care in the conununity. Commissioners and providers of services should address a number of methodological considerations when using cost information to purchase services or review their competitiveness or cost-effectiveness. Principles for using information are offered, including comprehensiveness, taking account of variations, making comparisons and linking costs with outcomes. The wider implications for commissioners and providers are then discussed in the context of policy issues and management concerns.