{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:52:10Z","timestamp":1791193930832,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ageing"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This paper reports the health economic component of the broader Promoting Independence Through Quality Dementia Care at Home (PITCH). The broader PITCH trial primarily evaluated the effect of dementia training on home care workers' competence in providing dementia care; this analysis evaluated intervention costs and selected secondary client and caregiver outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The PITCH intervention was tested via a multi\u2010site national pragmatic stepped\u2010wedge cluster randomised clinical trial, conducted across three Australian states. A micro\u2010costing approach was used to estimate intervention and resource use costs. Secondary outcomes for clients and caregivers, including quality of life (QoL), caregiver burden and dyadic interaction, were assessed. Means (SDs) described costs and outcomes, with linear and multilevel mixed\u2010effects regression used to estimate crude and adjusted mean differences, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were no significant improvements in most client and caregiver health, QoL, caregiver burden or dyadic interaction outcomes during the intervention phase, with decreases in proxy\u2010reported Dementia QoL Utility (DEMQOL\u2010U) and client self\u2010reported visual analogue scale (EQ VAS). Improvements in caregiver burden and dyadic interaction were observed but were not statistically significant. Total costs increased from AU$68,925 in the control to AU$133,660 in the intervention phase, with an adjusted mean difference of AU$67,146 (95% CI: AU$16,957 to AU$117,334).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This health economic analysis should be interpreted separately from and alongside, the main PITCH trial findings on the primary outcome of home care workers' competence. Within this secondary analysis, PITCH was associated with higher total costs during the intervention phase and no clear evidence of improvement in the selected secondary client and caregiver outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajag.70239","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T09:01:24Z","timestamp":1791190884000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010Consequence Analysis of a Dementia Specialist Training Program for Home Care Workers: Results From a Stepped\u2010Wedge Cluster\u2010Randomised Controlled Trial"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-3857","authenticated-orcid":false,"given":"Yared Belete","family":"Belay","sequence":"first","affiliation":[{"name":"Health Economics Group, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-5926","authenticated-orcid":false,"given":"Anita","family":"Goh","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne Victoria Australia"},{"name":"National Ageing Research Institute  Melbourne Victoria Australia"},{"name":"Edith Cowan University  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4186-314X","authenticated-orcid":false,"given":"Briony","family":"Dow","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne Victoria Australia"},{"name":"National Ageing Research Institute  Melbourne Victoria Australia"},{"name":"Deakin University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa","family":"Dang","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne Victoria Australia"},{"name":"National Ageing Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Savvas","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne Victoria Australia"},{"name":"National Ageing Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7302-7293","authenticated-orcid":false,"given":"Frances","family":"Batchelor","sequence":"additional","affiliation":[{"name":"The University of Melbourne  Melbourne Victoria Australia"},{"name":"National Ageing Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7959-3149","authenticated-orcid":false,"given":"Lidia","family":"Engel","sequence":"additional","affiliation":[{"name":"Health Economics Group, School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"2","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/01621424.2018.1438952","article-title":"Home Care in Australia: An Integrative Review","volume":"37","author":"Palesy D.","year":"2018","journal-title":"Home Health Care Services Quarterly"},{"key":"e_1_2_13_3_1","unstructured":"Australian Bureau of Statistic \u201c421231 Community Aged Care Support Worker \u201daccessed 28 July 2026 https:\/\/www.abs.gov.au\/statistics\/classifications\/osca\u2010occupation\u2010standard\u2010classification\u2010australia\/2024\u2010version\u20101\u20100\/browse\u2010classification\/4\/42\/421\/4212\/421231."},{"key":"e_1_2_13_4_1","unstructured":"Department of Health DaA \u201cAbout Aged Care \u201daccessed 28 July 2026 https:\/\/www.health.gov.au\/topics\/aged\u2010care\/about\u2010aged\u2010care?language=en."},{"key":"e_1_2_13_5_1","unstructured":"Unite healthcare \u201cHome Care Or Residential Care? 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