Abstract
BackgroundThe adult social care outcomes toolkit (ASCOT) includes a preference-weighted measure of social care-related quality of life for use in economic evaluations. ASCOT has eight attributes: personal cleanliness and comfort, food and drink, control over daily life, personal safety, accommodation cleanliness and comfort, social participation and involvement, occupation and dignity. This paper aims to demonstrate the construct validity of the ASCOT attributes.MethodsA survey of older people receiving publicly-funded home care services was conducted by face-to-face interview in several sites across England. Additional data on variables hypothesised to be related and unrelated to each of the attributes were also collected. Relationships between these variables and the attributes were analysed through chi-squared tests and analysis of variance, as appropriate, to test the construct validity of each attribute.Results301 people were interviewed and approximately 10% of responses were given by a proxy respondent. Results suggest that each attribute captured the extent to which respondents exercised choice in how their outcomes were met. There was also evidence for the validity of the control over daily life, occupation, personal cleanliness and comfort, personal safety, accommodation cleanliness and comfort, and social participation and involvement attributes. There was less evidence regarding the validity of the food and drink and dignity attributes, but this may be a consequence of problems finding good data against which to validate these attributes, as well as problems with the distribution of the food and drink item.ConclusionsThis study provides some evidence for the construct validity of the ASCOT attributes and therefore support for ASCOT's use in economic evaluation. It also demonstrated the feasibility of its use among older people, although the need for proxy respondents in some situations suggests that developing a version that is suitable for proxies would be a useful future direction for this work. Validation of the instrument on a sample of younger social care users would also be useful.
Highlights
The adult social care outcomes toolkit (ASCOT) includes a preference-weighted measure of social care-related quality of life for use in economic evaluations
If we want to measure the value of social care services we need a measure that reflects the compensatory activity of social care, is sensitive to choice and captures what we have termed social care-related quality of life (SCRQoL), which reflects those aspects of QoL, or attributes, that are the focus of social care support
Ethics approval was obtained from the University of Kent Ethics Committee and research governance approval from each of the Local Authorities (LAs) that agreed to participate in the study
Summary
The adult social care outcomes toolkit (ASCOT) includes a preference-weighted measure of social care-related quality of life for use in economic evaluations. Social care services tend to compensate people for the effect of their impairments on their quality of life (QoL) in accordance with local and national policies. Services aim to do this in a way that is enabling and allows people to make choices as to how their needs are met. If we want to measure the value of social care services we need a measure that reflects the compensatory activity of social care, is sensitive to choice and captures what we have termed social care-related quality of life (SCRQoL), which reflects those aspects of QoL, or attributes, that are the focus of social care support. To generate a single score for use in cost-effectiveness analyses it should be preference-weighted to reflect the relative importance of the SCRQoL states [6]
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