ABSTRACT
This chapter analyses the costs of care of older people with dementia receiving an intensive care management service compared to those incurred by a similar group receiving the usual modes of care. The Lewisham Case Management Scheme (LCMS) provided care that was more expensive than standard services. There were higher costs to the NHS in respect of acute hospital care for those in the experimental group, possibly attributable to the needs of older people who may otherwise have been admitted to a long-term care setting. Their acute medical needs may have been met without recourse to hospital admission had they not received intensive case management. Costs to the control group were higher in respect of longterm care admissions, primarily to residential and nursing home care, reflecting the paucity of domiciliary care compared to that available in the experimental group primarily in the form of the paid helper service.
