AbstractThe present health, care and support mechanisms are unable to truly meet the demands made upon it. Between 1992 and 1996 the total number of home care hours increased by 50% while the number of households receiving the service declined by around 7%. A more intensive service is being delivered to a minority of people yet at the same time the number of people who may need support is increasing. Health spending on people aged 75 and over is 6 times that of the average for the rest of the population but between 1995 and 2025 the UK will see a 43.6% increase in the 60 and over age range. A similar trend is apparent across much of the developed world.
In order to meet this new demand the use of technology has been suggested, yet a review of the literature indicates that little evidence exists to indicate if users would welcome technology and whether it would be effective. This research therefore seeks to answer the question ‘Are assistive technologies an enhancement to the present health, care and support mechanisms?’ The NHS and Community Care Act 1990 suggests that resources should move from hospitals and institutions to the community and therefore since 80% of older people want to stay in their own homes it would seem appropriate that assistance is provided to people in these locations. The literature review has also highlighted 4 key areas, which are addressed in this thesis, namely: user requirements, system modelling, cost analysis and service delivery.
Currently relatively simple technology, refereed to as the community alarm system is used to assist, predominately older people, in the community. Using these people and the technology as a base level this research indicates that such users would welcome more advanced technology. Indeed, in a survey of 176 users, 77% welcomed automatic fall detection, 68% welcomed lifestyle monitoring where changes in the pattern of behaviour generates an automatic alarm, 57% welcomed telemedicine where medical parameters are measured in the users home and the doctor is contacted if necessary, and 46% welcomed videoconferencing.
To assist people in their own homes telecare has been defined as an appropriate model with the community alarm system being defined as the 1st generation system. Several authors have attempted to define subsequent generations of telecare in generalities with no one defining the actual system and data flows. To address this insufficiency, and provide a structure to developments, based on the availability of technology and the views of users, a target system has been defined which could be available within 15 years. In order to move from the present 1st generation system to this 4th generation, 2 stepping stone systems have been defined and it is hoped that subsequent work will use these system definitions and create and trial the technology and systems suggested.
Telecare is an emerging area of research and therefore little attention has been given to costeffectiveness, in order to address this area a financial model has been created using Excel worksheets. The results indicate that, in comparison to the present system a 2nd generation telecare system could potentially save £8.3m over the 10-year system life cycle. Various sensitivity analyses are performed and in each and every constraint the 2nd generation telecare system is more profitable than the present community alarm system. Extrapolating the results to represent the whole of the UK indicates that there is the potential to save £832m over the 10-year system life cycle.
As with any system the introduction of a 2nd generation telecare system will inevitably change the way people work. In order to discover the impact that the introduction of such a system may have a model has been created to estimate the impact at the community alarm control centre, currently the centre of activity in the present system. The net result is that the number of calls increases by 321%, however many of these calls regard data that do not require human attention. When analysing the impact on service delivery the actual amount of time required speaking to people in need of assistance reduce by 55%. This is predominantly achieved by reducing the number of calls activated by mistake through the greater use of effective technology. Overall it could be argued that this research has added considerably to the knowledge base and the results indicate that telecare has tremendous potential to address the ageing population difficulties that the UK and other developed countries face.
|Date of Award||Mar 2001|
|Sponsors||TeleLarm & HET software|
|Supervisor||David A. Bradley (Supervisor)|