A systematic review of the effectiveness and cost- effectiveness of different models of community-based respite care for frail older people and their carers

Citation Mason, A., Weatherly, H., Spilsbury, K., Arksey, H., Golder, S., Adamson, J., Drummond, M., & Glendinning, C. (2007). A systematic review of the effectiveness and cost- effectiveness of different models of community-based respite care for frail older people and their carers. Health Technology Assessment, 11 (15), 1-157.

Design Meta-analysis

Purpose The purpose of this meta-analysis was to review the evidence for different models of community-based respite care for frail older people and their caregivers. Where data permitted, subgroups of caregivers and care recipients, for whom respite care is particularly effective or cost-effective, were to be identified.

Procedure Data from relevant studies were extracted and quality assessed. The possible effects of study quality on the effectiveness data and review findings were discussed. Where sufficient clinically and statistically similar data were available, data were pooled using appropriate statistical techniques.

Outcomes Evidence suggests that the consequences of respite upon caregivers and care recipients are generally small, with better controlled studies finding modest benefits only for certain subgroups. However, many studies reported high levels of carer satisfaction. No reliable evidence was found that respite can delay entry to residential care or that respite adversely affects care recipients. All of the quasi-experimental and uncontrolled studies had methodological weaknesses. Overall, the literature review provides some evidence that respite for caregivers of frail elderly people may have a small positive effect upon caregivers in terms of burden and mental or physical health. Caregivers were generally very satisfied with respite. No reliable evidence was found that respite either benefits or adversely affects care recipients, or that it delays entry to residential care. Economic evidence suggests that day care is at least as costly as usual care.

Author Mason, A., Weatherly, H., Spilsbury, K., Arksey, H., Golder, S., Adamson, J., Drummond, M., & Glendinning, C.