Costing the hospital-based process of resettling people with learning disability in the community

Much has been written about the costs and cost-effectiveness of community care for people with learning disabilities resettled from long stay hospital care. However, comparatively little has been published about the cost of hospital services relating to the preparatory process before eventual resettlement and the disengagement of formal, sustained input from hospital staff. This study describes and costs the input provided by a hospital based multi-disciplinary team into the resettlement of adults with learning disabilities from long stay wards in Muckamore Abbey Hospital in Northern Ireland between 1996 and 1999 (n = 71).

The study employs a retrospective survey design. Information about the nature and frequency of the input of each member of hospital multi-disciplinary team was collected for each former client. According to the level of professional resources expended during the resettlement process, each former client was then categorised into one of three categories. One case was then selected at random to represent each category. A summary of clinical information, a description of the resettlement process and an estimate of the cost of the process was provided for each case.

Approximately 55% of people resettled in the community during the study period did so with a modest degree of input from hospital staff. For 18% resettlement proved to be a demanding and prolonged process, requiring intensive input from hospital staff. Financial costs of the resettlement process ranged from approximately stg£1,500 to stg£8,000, with an average of stg£3,400 for each person.

This study provides evidence of the input by hospital staff into the process of community resettlement of long stay hospital clients and the associated costs. These costs must be included in service budgets if quality care and appropriate service provision is to be maintained in resettlement practice.