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Funding and resource decision-making for adult social care – the role of cost-effectiveness analysis

Forder, Julien E. and Roland, Daniel (2021) Funding and resource decision-making for adult social care – the role of cost-effectiveness analysis. Technical report. National Institute for Health and Care Research (Unpublished) (KAR id:97754)


Policy makers, operating with finite public budgets and facing increasing need, have choices in what care and support to fund. Cost-effectiveness analysis (CEA) is an approach that can help with these choices. This paper is concerned with the social care system in England, the system of long-term care and support for people with impairment, frailty and disability. CEA is a tool to determine the optimal allocation of scarce resources which embodies certain principles, value judgements and assumptions (Levin and McEwan, 2001). This approach is used extensively in healthcare but less so in social care. The aim of this paper is to identify the issues and potential developments that would support further use of CEA in adult social care. We focus on three areas. First, the need to establish whether the underpinning values of the care system justify a cost-effectiveness approach. These value judgements and concepts that underpin a CE approach have not been widely debated in the social care arena and are, arguably, not part of the routine discourse, nor practice in this field. Second, to consider how economic evaluation methodologies apply in social care (to be used to produce evidence for CEA). Third, with how CEA evaluation evidence can be used to inform decision-making, particularly the use of a cost-effectiveness threshold, and how a threshold might be determined for social care.

Item Type: Reports and Papers (Technical report)
Uncontrolled keywords: long-term care; social care; cost-effectiveness analysis
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Personal Social Services Research Unit
Depositing User: Daniel de Araujo Joao Roland
Date Deposited: 02 Nov 2022 14:41 UTC
Last Modified: 03 Nov 2022 14:38 UTC
Resource URI: (The current URI for this page, for reference purposes)

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