Online Program

Assess cost effectiveness of the multidisciplinary approach to elder abuse: Economic evaluation of elder abuse forensic center model

Monday, November 2, 2015

Michael B. Nichol, PhD, Sol Price School of Public Policy, University of Southern Calfiornia, Los Angeles, CA
Joanne Wu, MD, MS, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA
Zachary D. Gassoumis, PhD, University of Southern California
Elder abuse forensic centers (EAFCs) use a multidisciplinary approach that integrates health care, social service, and legal service to address complex elder abuse cases.  Currently, no evaluation has assessed the cost for EAFCs to achieve their outcomes.  This study evaluates the cost effectiveness of the Los Angeles County EAFC.

We analyzed case files for 41 randomly selected cases seen at EAFC and 39 propensity-matched Adult Protective Service (APS) usual care cases from 2007-2009 to obtain data on time spent processing cases and achieving outcomes.  Publicly available salaries were used to estimate case processing costs.  Mean case processing costs are $1,101.80 for EAFC and $153.30 for usual care. The proportion of cases submitted to the public guardian is 39% for EAFC and 8% for usual care, which generates an incremental cost-outcome ratio (ICOR) of $3,059.68.  The ICOR indicates that an additional EAFC case submitted to the public guardian costs an additional $3,059.68 over the usual care cost.  The proportion of cases that are granted conservatorship is 24% for EAFC and 3% for usual care, with an ICOR of $4,516.67.  The proportion of cases successfully prosecuted is 17% for EAFC and 0.2% for usual care, with an ICOR of $5,645.83.  There were no differences in recurrence rates within one year of case closure.

These results indicate the EAFC model incurs greater case processing costs but yields large incremental differences in outcomes compared to usual care. This information can inform the sustainability of the model and the feasibility of replication across the U.S.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Social and behavioral sciences

Learning Objectives:
Define and discuss outcome measurements of elder abuse cases; Define and discuss cost differences in processing elder abuse cases between the elder abuse forensic center model approach and Adult Protective Service (APS) usual care; Define and discuss estimation of an incremental cost-outcome ratio (ICOR) to determine the cost effectiveness of the elder abuse forensic center model

Keyword(s): Economic Analysis, Social Work

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I’m a key statistician/programmer analyst for projects funded by NIH, NIJ and various private organizations. My research has focused on health service delivery and cost, health behavior, and health economics, quality of life, and health utility measurement. My previous research has involved cost effectiveness of a variety of pharmaceuticals, and the evaluation of healthcare interventions, econometric modeling, and healthcare cost studies. I have extensive experience analyzing health claims through a variety of entities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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