EXCELC: Exploring Comparative Effectiveness and Efficiency in Long-term Care

To meet societal and economic challenges, health and care welfare regimes will need to become much more focused on the outcomes that matter to people and deliver these programmes effectively and efficiently. Central to this goal is the need to accurately measure outcomes and reflect the value of those outcomes. We propose a cross-country study to measure outcomes in the field of long-term care (LTC). We will use a care-related outcome tool, ASCOT, to assess the comparative effectiveness and efficiency of non-institutional LTC (e.g. home care) for older adults and their informal carers in Austria, England and Finland.

The study has four analytical workpackages (WPs) with these goals:

  • Establish a valid basis for international comparisons of LTC-outcomes in non-institutional settings, by developing rigorously translated and tested versions of ASCOT.
  • Generate country-specific ASCOT utility weights and explore variations in preferences for ASCOT quality of life domains across countries.
  • Explore variations in ASCOT quality of life (QoL) within and between countries, providing evidence on QoL-outcomes of services for service users and their carers.
  • Explore and compare the relative costs, efficiency and cost-effectiveness of specific LTC services. We will use econometric methods, combining estimates of the effect of services on QoL and service cost.

This study should strengthen the research base and help guide policy-makers and practitioners to make outcomes-focused, economically-sound decisions about LTC. It will also provide useful tools for future evaluations.

One of the applicants will lead each WP, supported by a country lead and team of researchers.

Research Team

Prof. J.E. Forder
University of Kent at Canterbury

Prof. I.E.O. Linnosmaa
National Insitute for Health and Welfare Helsinki

J.N. Malley
London School of Economics and Political Science

Dr. B. Trukeschitz
Vienna University of Economics and Business