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Table 4 Summary of results pertaining to processes of care

From: Advancing aged care: a systematic review of economic evaluations of workforce structures and care processes in a residential care setting

Intervention Source Effectiveness Cost Randomised design Key findings
Dementia-specific care
 Person-centred care (PCC) vs. usual care (UC)
 Person-centred environment (PCE) vs. UC
 Both (PCC + PCE) vs. UC 		[39] +
+
Unclear 		+
+
+ 		Yes Person-centred care has the potential to reduce agitation and aggression in residents living with dementia
Disparate implementation methods and mixed findings suggest a need for future research to examine the cost-effectiveness of person-centred care as well as different methods for assessing clinically-relevant quality of life
 PCC vs. UC
Dementia-care mapping (DCM) vs. UC 		[31, 32] +
+ 		+
+ 		Yes
 Dementia-care mapping (DCM) vs. usual care [30] 0 0 Yes
 A.G.E. dementia care program (activities, medication guidelines, educational rounds) vs. usual care [27] + + Yes For an additional cost, activity programs and psychiatric care can reduce behavioural symptoms, antipsychotic medications, and restraints, as well as increase activity participation rates for residents with dementia
Integrated care
 Multidisciplinary Integrated Care model vs. UC [22] Unclear + Yes There is limited cost-saving potential for integrated care in nursing homes
If there was unmet care, a multidisciplinary integrated model could address this gap; however a trade-off must be made as to whether the additional benefit is worth the additional cost
 Integrated care vs. traditional care [21] NA + No
Quality improvement initiatives
 Advance Directive program vs. usual care [25] 0 – Yes Activity programs aimed at reducing health care utilisation and hospitalisations have the potential to create cost savings from a broader health care perspective
 INTERACT II tools (interventions to reduce acute care transfers) [43] + + No
 Multifactorial fracture prevention program provided by a multidisciplinary team vs. no prevention in newly admitted nursing home residents [33] + + No
 Multilevel intervention with expert nurses vs. monthly info packs on ageing and physical assessment [26] + + Yes It is possible for facilities in need of quality of care improvements to build the organisational capacity to improve while not increasing staffing or costs of care
  1. Effectiveness + intervention provides greater health benefit than comparator; 0 intervention provides equivalent health benefit to comparator; − intervention provides lower health benefit than comparator
  2. Cost + intervention costs are higher than comparator; 0 intervention costs are equal to comparator; − intervention costs are lower than comparator
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