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Modelling long-term cost-effectiveness of health promotion for community-dwelling older people

Zingmark, Magnus LU ; Norström, Fredrik ; Lindholm, Lars ; Dahlin-Ivanoff, Synneve LU and Gustafsson, Susanne (2019) In European Journal of Ageing 16(4). p.395-404
Abstract

The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For... (More)

The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For each intervention and a no-intervention control group, we calculated the accumulated quality-adjusted life years (QALYs) and societal costs over 4 years. Sensitivity analyses included higher intervention costs, lower intervention effects and additional intervention costs and effects related to booster sessions. The results of all analyses indicated that health promotion implemented for community-dwelling older people in the format of senior meetings or a preventive home visit was cost-effective. Both interventions lead to QALY gains and reduce societal costs at any follow-up over 4 years, and thus, resources can be used to implement other interventions. The most important factor for the magnitude of QALY gains and cost savings was the intervention effect. Yearly booster sessions implemented for those persons who maintained their level of functioning extended the intervention effects adding additional QALYs and further reducing societal costs.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
European Journal of Ageing
volume
16
issue
4
pages
395 - 404
publisher
Springer
external identifiers
  • pmid:31798365
  • scopus:85062045626
ISSN
1613-9372
DOI
10.1007/s10433-019-00505-1
language
English
LU publication?
no
additional info
© The Author(s) 2019.
id
b6cd2e51-ddd8-4fac-bb9e-32afb9cd951e
date added to LUP
2020-05-29 16:40:38
date last changed
2020-10-07 06:59:26
@article{b6cd2e51-ddd8-4fac-bb9e-32afb9cd951e,
  abstract     = {<p>The effectiveness of health promotion for community-dwelling older people is well documented; however, there is a general lack of health economic evaluations. The aim of the present study was to evaluate long-term cost-effectiveness over 4 years of two health promoting interventions: senior meetings and a preventive home visit, for community-dwelling older people in relation to no intervention. We applied a Markov model including five states defined in relation to level of dependency of home help and place of residency. The model included transitions between dependency states, scores for quality of life and societal costs for each state, intervention costs and intervention effects for two formats of health promoting interventions. For each intervention and a no-intervention control group, we calculated the accumulated quality-adjusted life years (QALYs) and societal costs over 4 years. Sensitivity analyses included higher intervention costs, lower intervention effects and additional intervention costs and effects related to booster sessions. The results of all analyses indicated that health promotion implemented for community-dwelling older people in the format of senior meetings or a preventive home visit was cost-effective. Both interventions lead to QALY gains and reduce societal costs at any follow-up over 4 years, and thus, resources can be used to implement other interventions. The most important factor for the magnitude of QALY gains and cost savings was the intervention effect. Yearly booster sessions implemented for those persons who maintained their level of functioning extended the intervention effects adding additional QALYs and further reducing societal costs.</p>},
  author       = {Zingmark, Magnus and Norström, Fredrik and Lindholm, Lars and Dahlin-Ivanoff, Synneve and Gustafsson, Susanne},
  issn         = {1613-9372},
  language     = {eng},
  number       = {4},
  pages        = {395--404},
  publisher    = {Springer},
  series       = {European Journal of Ageing},
  title        = {Modelling long-term cost-effectiveness of health promotion for community-dwelling older people},
  url          = {http://dx.doi.org/10.1007/s10433-019-00505-1},
  doi          = {10.1007/s10433-019-00505-1},
  volume       = {16},
  year         = {2019},
}