Economic evaluation of the annual and daily costs of the adult foster care model for older dependent adults: Insights from the Karukera Study of Aging in Foster Families
Denis Boucaud-Maitre, Damien Krier, Hélène Amieva, Jean-François Dartigues, Jérôme Wittwer, Maturin Tabué-TeguoAbstract
Background and Objectives
Adult foster care may represent a viable alternative to nursing homes for dependent older adults. This study aimed to estimate the annual and daily cost of adult foster care for older adults.
Research Design and Methods
The Karukera Study of Aging in Foster Families is a prospective, one-year observational study including adults aged 60+ living in adult foster care in the French Caribbean Islands. We measured healthcare resource utilization using the RUD (Resource Utilization in Dementia)-Lite instrument. Costs related to healthcare consumption, foster caregiver remuneration, and training were estimated and expressed per patient-year.
Results
A total of 106 older adults (mean age: 82.2±11.2 years; 61.3% women) were followed for one year (mean follow-up duration: 306.1±90.8 days). The daily cost of outpatient care was estimated at €33.3, of which €29.9 corresponded to community nursing visits. Caregiver remuneration and training represented a daily expenditure of €62.8 per older adult. The total annual cost of adult foster care was estimated at €35,076, or €96.1 per resident per day. Hospitalization costs were estimated at €224.0 per patient-year, while emergency department visits accounted for €42.0 per patient-year.
Discussion and Implications
Compared with a daily cost of €121 per resident in metropolitan nursing homes and €150 per resident in nursing homes in the French Caribbean Islands, adult foster care reduced costs by 20.6% and 35.9%, respectively. In the context of constrained healthcare budgets and increasing demand for long-term care related to dependency, adult foster care may represent a scalable and economically sustainable alternative.
Clinical Trial Registration
NCT04545775