Social and health conditions that drive the need, demand, utilisation and expenditure on social care in the United Kingdom: a protocol for a systematic review

BackgroundSocial care is the personal and practical assistance provided to individuals in their daily activities, personalised around their circumstances to promote wellbeing. It is provided by formal and informal carers, with formal care supported by considerable public resources through the Adult Social Care function of local authorities. While it is a matter of great public and policy concern that the system better meet peoples needs and that public finances are not unsustainably strained, some key drivers of adult social care need, such as the relationships between age, social determinants, environmental conditions, and health status are not well understood at the system level. This is a protocol for a systematic review of the evidence to determine the health and social drivers that contribute to adults need and demand for and utilisation of social care in the UK, and how these interact. MethodsWe will include quantitative studies of any experimental, observational or simulation/modelling design with average participant age [≥]60, that examine the relationships between health status and/or social conditions, and their impact on adult social care need, demand, utilisation and expenditure. Informal and formal domiciliary, residential and nursing care, professional social work and occupational therapy will be included. Medline, CINAHL, EconLit, ASSIA Campbell Collaboration and grey literature will be searched. A single reviewer will screen titles/abstracts for eligibility, and two reviewers will independently screen the full-text of studies initially considered eligible. 15% of the included studies will be double-extracted, and remainder single extracted with an accuracy check. Risk of bias will be assessed using Cochrane Risk of Bias 2 and ROBINS-I. The findings will be grouped by health condition(s), the type of determinant, outcome and will be presented in an evidence gap map. If three or more comparable studies are identified, we will consider calculating the effect size. We will use GRADE to assess the evidence certainty. DiscussionWe will detail the evidence on the relationships (to include an indication of their contribution) between health status and social conditions with the need, demand, utilisation and expenditure on adult social care in the UK, informing further analyses in key evidence gaps.