Training care givers of stroke patients: economic evaluation

doi:10.1136/bmj.328.7448.1102

BMJ 2004;328:1102 (8 May), doi:10.1136/bmj.328.7448.1102

Paper

Training care givers of stroke patients: economic evaluation

Anita Patel, lecturer in health economics¹, Martin Knapp, professor of health economics¹, Andrew Evans, clinical lecturer in stroke medicine², Inigo Perez, research fellow², Lalit Kalra, professor of stroke medicine²

¹ Centre for the Economics of Mental Health, Institute of Psychiatry, London SE5 8AF, ² Department of Medicine, Guy's, King's and St Thomas's School of Medicine, London SE5 9PJ

Correspondence to: L Kalra lalit.kalra{at}kcl.ac.uk

Background Training care givers reduces their burden and improvespsychosocial outcomes in care givers and patients at one year.However, the cost effectiveness of this approach has not beeninvestigated.

Objective To evaluate the cost effectiveness of caregiver trainingby examining health and social care costs, informal care costs,and quality adjusted life years in care givers.

Design A single, blind, randomised controlled trial.

Setting Stroke rehabilitation unit.

Subjects 300 stroke patients and their care givers.

Interventions Caregiver training in basic nursing and facilitationof personal care techniques compared with no care giver training.

Main outcome measures Health and social care costs, informalcare costs, and quality adjusted life years in care givers overone year after stroke.

Results Total health and social care costs over one year forpatients whose care givers received training were significantlylower (mean difference -£4043 ($7249; ${euro}$ 6072), 95% confidenceinterval -£6544 to -£1595). Inclusion of informalcare costs, which were similar between the two groups, did notalter this conclusion. The cost difference was largely due todifferences in length of hospital stay. The EQ-5D did not detectchanges in quality adjusted life years in care givers.

Conclusion Compared with no training, caregiver training duringrehabilitation of patients reduced costs of care while improvingoverall quality of life in care givers at one year.

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