PhD: Enhancing quality in social care through economic analysis

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Population ageing has motivated policy makers around the world to focus on how best to organise health and social care services to meet an anticipated growing demand on services. Two popular initiatives are re-ablement and telecare. Re-ablement is an approach within homecare that enables older individuals with social care needs to improve their functional performance and live independently. Telecare, on the other hand, involves use of devices to monitor individuals’ health and safety, and provide response when needed. Evidence from the existing literature suggests that there are few economic studies investigating the effects of re-ablement and telecare, especially in Scotland. The generalisability of the existing studies is also questionable given that most of them have small sample sizes and high attrition rates. To this end, we undertook economic analyses of linked administrative health and social care data in Scotland. Our estimation strategy controlled for potential selectivity bias, endogeneity of key variables and unobserved heterogeneity in tandem. 


Outcome and Translation

The findings from this thesis informed the factors associated with better outcomes; helped identify the groups of people that are most likely to benefit from the interventions; and showed the relative importance of telecare in improving outcomes.  More specifically, it was shown that some of forms of telecare (community alarms) were associated with a reduced probability of admission to hospital in the emergency department, whilst other types of telecare had the opposite effect.  Further, those living in remote areas, and those living with multiple conditions, were also more likely to be admitted as emergency cases.  Finally, some form of telecare (community alarms) were associated with reduced length of hospital stay amongst some patients (those with physical disability).


PhD Student: Kevin Momanyi

Supervisor: Paul McNamee and Diane Skåtun


Momanyi, K. (2019) 'Enhancing quality in social care through economic analysis', PhD Thesis, HERU, University of Aberdeen.



Momanyi, K., McNamee, P. and Skåtun, D. (2016) 'Enhancing quality in social care through economic analysis', PhD Health and Social Care Symposium, Farr Institute, NHS National Services Scotland, Edinburgh, 22 June 2016.

Momanyi, K., McNamee, P. and Skåtun, D. (2016) 'Enhancing quality in social care through economic analysis', Institute of Applied Health Sciences (IAHS) Postgraduate Research Student Symposium, University of Aberdeen, Aberdeen, 24 June 2016.

Momanyi, K. and McNamee, P.  (2017) 'Reducing unplanned hospitalisation in Scotland: is it time to consider telecare?', School of Medicine, Medical Sciences and Nutrition Postgraduate Research Conference, University of Aberdeen, Aberdeen, 29 November 2017.