Proposed is a study of inputs and costs associated with Special Care Units (SCUs) for demented elderly residents of long term residential health care facilities (LTRHCFs). This project would build upon an ongoing study (the parent study) of 960 residents in 32 LTRHCFs of impacts associated with SCU care. A subsample of 12 facilities would be site visits make by parent project staff, thus Enabling use of extensive resident-level data collected as part of the parent project. During the proposed site visits extensive data concerning service inputs, primarily personal services but also including selected other than personal (OTPS) costs, e.g., medications, would be obtained. Service input data -- category, provider, recipient, and duration using service barcodes and portable wands carried by facility staff, together with comprehensive software systems previously developed by the applicant. As the central goal is to determine whether there are differential costs associated with SCU care as contrasted with non-SCU care, and with different subgroups among demented residents, service and OTPS will be monetized according to prevailing average rates across the states involved in the study. Bivariate analysis will be used to determine whether there are SCU/non-SCU cost differences. Multivariate analyses will be used to determine whether different levels of cognitive impairment are significantly and meaningfully related to differences in input costs. Cost effect and cost benefit modelling will be used to address policy concerns relating to calculating case mix based reimbursement rates.
