Effectiveness and cost-related outcomes of respite care models for people with functional disability and dementia and their caregivers: A systematic review.

BACKGROUND AND OBJECTIVES: Respite care is widely used to support caregivers of individuals with disabilities and dementia. However, the comparative effectiveness and cost-related outcomes of different respite care models remain unclear. This systematic review aimed to evaluate the impact of various respite care interventions on both caregivers and care recipients. RESEARCH DESIGN AND METHODS: A systematic review was conducted following PRISMA guidelines. We searched 10 databases from inception to March 9, 2025. The Cochrane Risk of Bias Tool 2.0, the Risk of Bias, and the Consensus on Health Economic Criteria checklist were used to evaluate the quality of the included studies. RESULTS: Eight studies (three RCTs, five quasi-experimental), including 1,420 care recipients and 1,610 caregivers, were analyzed. Four studies were judged to be at high risk of bias and four had some concerns. Interventions fell into two categories: (1) home-based respite care with additional support, effectively reducing caregiver stress but with limited reported effects on care recipients; (2) diversified respite care integrating home, institutional, and day-center services, reducing caregiver burden, improving mental health, quality of life, and extending care recipients' community-dwelling survival. Additionally, two studies reported cost-related data, but no full cost-effectiveness analyses were conducted. DISCUSSION AND IMPLICATIONS: Home-based and day-care programs may be associated with improvements in caregiver outcomes, although evidence regarding their cost-related outcomes remains limited. Overall, the findings should be interpreted cautiously given the generally high risk of bias among included studies. These findings provide preliminary insights for the development of flexible home- and community-based respite-support services.