Training care givers of stroke patients: economic evaluation.
BACKGROUND
Training care givers reduces their burden and improves psychosocial outcomes in care givers and patients at one year. However, the cost effectiveness of this approach has not been investigated.


OBJECTIVE
To evaluate the cost effectiveness of caregiver training by examining health and social care costs, informal care costs, and quality adjusted life years in care givers.


DESIGN
A single, blind, randomised controlled trial.


SETTING
Stroke rehabilitation unit.


SUBJECTS
300 stroke patients and their care givers.


INTERVENTIONS
Caregiver training in basic nursing and facilitation of personal care techniques compared with no care giver training.


MAIN OUTCOME MEASURES
Health and social care costs, informal care costs, and quality adjusted life years in care givers over one year after stroke.


RESULTS
Total health and social care costs over one year for patients whose care givers received training were significantly lower (mean difference -4043 pounds sterling (7249 dollars; 6072 euros), 95% confidence interval -6544 pounds sterling to -595 pounds sterling). Inclusion of informal care costs, which were similar between the two groups, did not alter this conclusion. The cost difference was largely due to differences in length of hospital stay. The EQ-5D did not detect changes in quality adjusted life years in care givers.


CONCLUSION
Compared with no training, caregiver training during rehabilitation of patients reduced costs of care while improving overall quality of life in care givers at one year.