Prolonging life at home: what is the cost?

This paper describes one of the first attempts at an economic evaluation of a community care initiative for elderly mentally infirm people and their carers. It is demonstrated that community support provided mainly through an innovative Family Support Unit (FSU) is almost three times more costly than that which would otherwise be provided. However, FSU support results in prolonged life at home for elderly mentally infirm people, thus saving costly long-term care beds. If life at home is preferable to long-term care, FSU care can be judged cost effective. However, regarding implementation of such schemes, cash-limited local authorities appear to be forced to take on schemes which, despite being cost effective when taking a broad range of resources into account, cost more than they save as far as the local authority itself is concerned.