Reprovision costs: comparing a detailed approach with interpolations

Since 1985 the Personal Social Services Research Unit has described and costed the individual packages of care receivedby 389 former long-stay psychiatric hospital in-patients during their first year in the community. The costs study is part of the evaluation monitoring the closure of the Friern and Claybury hospitals, two large Victorian institutions in North London. In order to cost a whole hospital closure programme, it is important that our picture of that population should be as complete as possible. It has not been possible to collect detailed information for all clients so, during 1993, existing data were used to interpolate costs for those people who had not been interviewed. This paper outlines the methodology used to interpolate costs and reports on the change the addition of the estimated costs group has made to our costs sample. Although the mean cost of community care across all cohorts of hospital leavers is similar in both groups (detailed costs £516, estimated costs £486, in 1992/93 prices) we found the majority of estimated service packages were at the top or the bottom of the costs range. We now have more information, on the one hand, of the number of clients living independently and, on the other, of those who returned to hospital for long periods. The latter group indicates the continuing dependence on in-patient hospital provision in North East Thames, a fact which should be borne in mind by policy makers, planners and purchasers in future reprovision programmes