This document summarizes the key findings of a 3-year longitudinal study comparing 162 new residents of ExtraCare retirement communities to a control group of 33 people living in their own homes. The study found that the ExtraCare model reduces total NHS costs for residents within the first 12 months and helps relieve pressure on GP surgeries. It also found a significant reduction in the duration of unplanned hospital stays for ExtraCare residents. Additionally, the ExtraCare model appears to offer significant savings in social care costs for local authorities and improves residents' health, well-being, mobility, and reduces depression over time.
10. What did it do?
3 year longitudinal study comparing 162 new ExtraCare
residents with a control group of 33 people living in their
own homes in the community.
Considered the effects of ExtraCare’s integrated
approach on health and well-being, cognition and their
influences on social functioning and independence over
time.
Compared the effect of the
ExtraCare model on care needs
and care costs.
12. The ExtraCare model reduces total NHS costs for individuals
from when they move in to 12 months late (costs for the
control group do not change)
13. ‘Growth in the older population is resulting
in unprecedented pressure on GPs’
The ExtraCare model’s Well-being Service helps relieve pressure on GP surgeries
14. This results in cost savings and efficiency savings
at a local level
15. ‘People over the age of 65 account for two-thirds
of emergency hospital admissions
i.e. 2 million admissions = 70% of bed days’
Living at ExtraCare is associated with a significant
reduction in the duration of unplanned hospital stays
16. ‘Local Authority spend on adult social care
decreased on average by 12% between 2010 and 2013’ (N.A.O.)
‘The Care Act requires increased focus on PREVENTION
AND WELL-BEING’
The ExtraCare model is likely to offer significant savings in the
cost of social care for local authority commissioners
17. A significant proportion of ExtraCare residents who were ‘pre-
frail’ at baseline have returned to a ‘resilient’ status
18 months later
18. Living at ExtraCare appears to remove
differences in relation to socio-economic status in terms of
people’s perceptions of their own health
i.e. the correlation between lack of means and lack of
well-being disappears over time
19. ‘More than 1 million older people
a year are diagnosed with
depression’
‘Isolation, chronic illness and
mobility issues are risk factors’
The ExtraCare model uses
activities, social interaction and
community building to promote
mental health & well-being
20. There is a significant reduction in those people
suffering from clinical levels of depression
21. ‘Loss of mobility amongst older people can have
profound consequences - physical, social and psychological’
The ExtraCare model appears to mitigate against this -
and mobility issues have a less important effect on mental
well-being over time
22. New residents at ExtraCare show a reliable initial
improvement in aspects of memory – and this is maintained
over time
Charity formed in 1988
Over 4,400 older people living in 3,879 homes
Across the Midlands and the North
14 retirement villages
And 17 smaller housing developments
7 Retirement villages in development
5,000 older people in the community supported through ExtraCare’s Activity Programmes
Over 1,500 staff
Nearly 60 charity shops
Around 3,000 volunteers
Award winning care for our well-being and dementia support
Formed in 2009 the Aston Research Centre for
Healthy Ageing seeks to advance successful ageing
by understanding, predicting and preventing
age-related degeneration.
RESEARCH
PURPOSE
Retirement communities are an important arena
to promote healthy ageing. The development
of these communities may help to promote
independence by sustaining both physical and
mental well-being. Little is known about how
such innovative housing models, with integrated
health and social care, impact on outcomes for
older people and the overall costs of care and
support. This three-year longitudinal study sought
to compare changes over time in care needs and
care costs for new residents of The ExtraCare
Charitable Trust with a control sample living in
the community. It also sought to examine the
effects of the integrated approach deployed by
The ExtraCare Charitable Trust on health and
well-being, cognition, social functioning and
independence over time.
RESEARCH
METHODOLOGY
In a three-year longitudinal study, 162 new ExtraCare
Charitable Trust residents were compared against 33
control participants. Quantitative measures of health,
well-being, cognitive ability and mobility were taken
at entry, three, 12 and 18 months and health and
social care usage and costs were monitored.
KEY METHODS
• ExtraCare Well-being Service data
• Self-recorded diary data
• Assessments with researchers:-
- Psychological well-being
(anxiety and depression, perceived health)
- Functional limitations and independence
(from managing one’s own finances to dressing)
- Mobility
- Cognitive tests
(language, attention, different types of memory)
- Frailty and Resilience profiles.
The ExtraCare Charitable Trust model can result
in significant savings for NHS budgets – over a
12 month period total NHS costs (including GP
visits, practice and district nurse visits and hospital
appointments and admissions) reduce by 38% for
ExtraCare residents in the sample across the period.
The ExtraCare Well-being Service provides accessible,
informal (drop-in) support, offering preventative healthcare
and ongoing day-to-day chronic illness care. ExtraCare
residents used their GP more than the control sample at
3 and 12 months due to their relatively poorer health. During
the 12 month period ExtraCare residents’ routine and planned
GP appointments reduced by 46% whilst drop-ins to the
Well-being Service increased. Whilst this is not directly related
at an individual level it does strongly support the drop-in
Well-being model.
The ExtraCare Charitable Trust model is
associated with a significant reduction in the
duration of unplanned hospital stays, from an
average of between 8-14 days to 1-2 days,
promoting the efficient use of hospital beds.
The research compared the cost of care provided at The
ExtraCare Charitable Trust to the cost of care provided in
people’s homes in the wider community. It showed that
ExtraCare’s model is likely to offer significant potential
savings in the cost of social care for local authority
commissioners. The cost of providing lower level social care
using the ExtraCare model was £1,270 less per person per
year (17.8% less) than providing the same level of care in
the wider community (on average, with variation by local
authority) and the cost of higher level social care was
£4,556 less (26% less) per person per year.
Frailty, and especially
‘pre-frail’ states are
changeable - however,
a significant number
(19%) of new ExtraCare
residents designated as
‘pre-frail’ at baseline
had returned to a
‘resilient’ state 18
months later.
The ExtraCare Charitable
Trust model seems to ‘level
the playing field’ by removing
differences in self-perceived
health which are initially
related to socio-economic
status. ExtraCare residents
who are socio-economically
disadvantaged improve in their
perceptions of their own health.
The ExtraCare Charitable
Trust model delivers a
14.8% reduction in
depressive symptoms
over 18 months.
This was
accompanied by a 64.3%
reduction in people with
significant ‘clinical level’
depression over the
same period.
Low mobility is a significant predictor of low
mood and depressive symptoms amongst older
people. However, after 18 months at ExtraCare
those with low mobility showed the greatest
reduction in depressive symptoms and those
whose mobility reduced over the period did not
generally become more significantly depressed.
At the end of the period, for ExtraCare
residents, serious depression can no longer be
predicted by mobility.
At baseline new ExtraCare residents had more difficulties with cognitive functions, independence, health perceptions, depression and anxiety than the control sample. After three months these differences have reduced and some have disappeared, with significant improvements in psychological well-being, memory and social interaction for the ExtraCare residents. At 18 months there is a 10.1% improvement in ExtraCare residents’
autobiographical memory.
Whilst age had an impact on cognition (memory etc) for both
ExtraCare residents and the control group, age only had an impact on change in functional limitations for control participants. This is a function of the fact that decisions to move into ExtraCare are needs related rather than
age related, but is also strong confirmation that age has less impact on self-perceived ability to cope when living in the integrated, supported environment provided by The ExtraCare Charitable Trust.
