The recognition of dementia enables the provision of safer care by considering, for example, accommodation and care needs and encouraging advanced decision-making. We aim to compare the cost and quality of a Memory-Clinic-based Service (MCS) with a traditional Community Mental Health Team (CMHT) service in two different geographical areas in the UK.
Using a retrospective case-note review, we studied two groups, each with 33participants. We examined all referrals received over the time frame of the study (4 months) from specific, predetermined GP practices in these two rural/suburban areas. A data extraction sheet to assess the quality of the service was developed for this study. Cost of services was assessed using Client Service Receipt Inventory (CSRI) which was adapted for this study.
The MCS was less costly than the CMHT service but the difference was not statistically significant. Both services offered a high-quality diagnostic service but we argue that the MCS service was able to offer more systematic and comprehensive care, including pre-diagnostic counselling, more systematic screening of blood tests for reversible causes of dementia/comorbidity, more extended cognitive examination and structured assessment tools, better evidence of signposting to the third sector as well as copying of letters to patients and carers.
The total costs to secondary care were less with the MCS-based service than the CMHT based service, but this difference was not statistically significant. Overall memory clinic service offered more comprehensive and Multidisciplinary service at no extra cost to secondary care.