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

Author

Listed:
  • Magnus Zingmark

    (Municipality of Östersund
    Umeå University)

  • Fredrik Norström

    (Umeå University)

  • Lars Lindholm

    (Umeå University)

  • Synneve Dahlin-Ivanoff

    (The Sahlgrenska Academy at the University of Gothenburg
    University of Gothenburg Centre for Ageing and Health (AgeCap))

  • Susanne Gustafsson

    (The Sahlgrenska Academy at the University of Gothenburg
    University of Gothenburg Centre for Ageing and Health (AgeCap))

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 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.

Suggested Citation

  • Magnus Zingmark & Fredrik Norström & Lars Lindholm & Synneve Dahlin-Ivanoff & Susanne Gustafsson, 2019. "Modelling long-term cost-effectiveness of health promotion for community-dwelling older people," European Journal of Ageing, Springer, vol. 16(4), pages 395-404, December.
    • Handle: RePEc:spr:eujoag:v:16:y:2019:i:4:d:10.1007_s10433-019-00505-1
    DOI: 10.1007/s10433-019-00505-1
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    References listed on IDEAS

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    1. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    2. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    4. Torbjørn Wisløff & Gunhild Hagen & Vida Hamidi & Espen Movik & Marianne Klemp & Jan Olsen, 2014. "Estimating QALY Gains in Applied Studies: A Review of Cost-Utility Analyses Published in 2010," PharmacoEconomics, Springer, vol. 32(4), pages 367-375, April.
    5. Evan Mayo-Wilson & Sean Grant & Jennifer Burton & Amanda Parsons & Kristen Underhill & Paul Montgomery, 2014. "Preventive Home Visits for Mortality, Morbidity, and Institutionalization in Older Adults: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-1, March.
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    Cited by:

    1. Anna Nivestam & Maria Haak & Albert Westergren & Pia Petersson, 2021. "Give Older Persons a Voice in the Society—By Using Information Compiled during Preventive Home Visits on a Societal Level," IJERPH, MDPI, vol. 18(14), pages 1-17, July.
    2. Anna Sagan & Małgorzata Gałązka-Sobotka & Piotr Czauderna & Aldona Frączkiewicz-Wronka & Katarzyna Badora-Musiał & Natalia Petka & Iwona Kowalska-Bobko, 2022. "Health Centres 75+ as a New Model to Improve Care for Older People in Poland," IJERPH, MDPI, vol. 19(12), pages 1-12, June.
    3. Yoshiaki Nomura & Mieko Shimada & Erika Kakuta & Ayako Okada & Ryoko Otsuka & Yasuko Tomizawa & Chieko Taguchi & Kazumune Arikawa & Hideki Daikoku & Tamotsu Sato & Nobuhiro Hanada, 2020. "Mortality- and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study," IJERPH, MDPI, vol. 17(24), pages 1-17, December.
    4. Mark Kattenberg & Pieter Bakx, 2021. "Substitute services: a barrier to controlling long-term care expenditures," European Journal of Ageing, Springer, vol. 18(1), pages 85-97, March.

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