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Evaluating the Cost Effectiveness of the Elder Abuse Forensic Center Model

NCJ Number
248556
Author(s)
Michael B. Nichol Ph.D.; Kathleen H. Wilber Ph.D.; Joanne Wu M.S.; Zachary D. Gassoumis Ph.D.
Date Published
October 2014
Length
15 pages
Annotation
This report examines elder abuse forensic centers (EAFCs) and their use of a multidisciplinary team approach to address complex elder abuse cases.
Abstract
Elder abuse forensic centers (EAFCs) use a multidisciplinary team approach to address complex elder abuse cases. To date, no evaluation has assessed the cost for EAFCs to achieve their outcomes. This study evaluates the cost effectiveness of the Los Angeles County EAFC. We analyzed case files for 41 randomly selected cases seen at the Los Angeles County EAFC and 39 propensity-matched APS usual care cases from April 2007-December 2009 to obtain data on time spent processing cases and achieving outcomes. Salaries were obtained from publicly available sources and used to estimate case processing costs. Mean case processing costs are $1,101.80 for the EAFC model and $153.30 for usual care. The proportion of cases submitted to the public guardian is 39% for EAFC and 8% for usual care, which generates an ICOR of $3,059.68. The ICOR indicates that an additional EAFC case submitted to the public guardian costs an additional $3,059.68 over the cost of usual care. The proportion of cases that are granted conservatorship is 24% for EAFC and 3% for usual care, with an ICOR of $4,516.67. The proportion of cases successfully prosecuted is 17% for EAFC and 0.2% for usual care, with an ICOR of $5,645.83. There were no differences in recurrence rates within one year of case closure. These results indicate the EAFC model incurs greater case processing costs but yields large incremental differences in outcomes compared to usual care. This information can inform the sustainability of the model and the feasibility of replication across the U.S.