From: Economic evaluations in community aged care: a systematic review
Title | Population Sample size and Country | Study design | Comparators | Perspective | Time horizon | Measure and Source of effectiveness data | Costs (Currency-Year) | Informal care-measurement and valuation | Source of cost data | Measure of Outcome | Conclusions |
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Cost utility analysis | |||||||||||
Cost-Utility Analysis of Preventive Home Visits program for Older Adults in Germany (Brettschneider et al., 2015) | 80+ years N = 304 Germany | RCT | Preventive home visits vs usual care | S | 18 months | Nursing home admissions RCT | Health care Client/family Informal care (Euro-2008) | Yes – patient recall, replacement cost method | Hospital, Nursing home and pharmacy Records, Self-report (resource use questionnaires) | QALY (EQ-5D-3 L) | Intervention unlikely to be cost effective |
Cost utility analysis of case management for frail older people: effects of a randomised controlled trial (Sandberg et al., 2015) | 65+ years N = 153 Sweden | RCT | Case management vs usual care | S | 12 months | Healthcare utilisation RCT | Health care Other sectors, Client/family Informal care Intervention (Euro-2011) | Yes - patient recall, opportunity cost method | Hospital register, Community care records, Self-report | QALY (EQ-5D-3 L) | Intervention was cost neutral and did not seem to have affected health-related quality of life |
Occupational therapy compared with social work assessment for older people. An economic evaluation alongside the CAMELOT randomised controlled trial (Flood et al., 2005) | 65+ years N = 321 UK | RCT | Occupational therapist led vs social worker led assessment | PS | 8 months | Dependency using the Community Dependency Index (CDI) RCT | Health care, Social care, Client/family (Pound sterling-2001) | No | Clinical records, Self-report (Cost questionnaire) | QALY (EQ-5D-3 L) | No difference in clinical and cost effectiveness |
Cost-effectiveness of integrated care in frail elderly using the ICECAP-O and EQ-5D: does choice of instrument matter? (Makai et al., 2014a) | 75+ years N = 352 Netherlands | Quasi-experiment | Integrated care vs usual care | S | 3 months | ADL-functions, experienced health, mental well-being, social functioning, QES | Health care, Social care, Client/family, Intervention costs, Informal care (Euro-2011) | Yes – resource use questionnaire, NM | Patient health records, Self-report (care use questionnaire) | Capability (ICECAP-O) QALY (EQ-5D-3 L) | WICM maybe cost-effective based on capability QALYs |
Cost effectiveness of the Walcheren Integrated Care Model intervention for community dwelling frail elderly (Looman et al., 2016) | 75+ years N = 377 Netherlands | Quasi-experiment | Integrated care vs usual care | S | 12 months | Functions, experienced health, mental well-being, social functioning QES | Health care, Social care, Client or family, Intervention costs, Informal care (Euro-2011) | Yes – resource use questionnaire, NM | Patient health records, Self-report (care use questionnaire) | QALY (EQ-5D-3 L) | The WICM is not cost-effective |
Cost effectiveness analysis | |||||||||||
Effects on health care use and associated cost of a home visiting program for older people with poor health status: A randomized clinical trial in the Netherlands (Bouman et al., 2008) | 70–84 years N = 330 Netherlands | RCT | Home visiting vs usual care | S | 24 months | Health care use RCT | Health care, Intervention costs (Euro-2003) | No | Health use databases | Self-Rated Health (SRH) | Home visiting program did not appear to have any effect on the health care use of older people with poor health and had a low chance of being cost-effective |
Cost effectiveness of a multi-disciplinary intervention model for community-dwelling frail older people (Melis et al., 2008) | 70+ years N = 151 Netherlands | RCT | Multi-disciplinary intervention vs usual care | HS | 6 months | Functional performance in ADL and IADL (GARS-3) and mental well-being (SF-20 MH scale) RCT | Health care, Social care (Euro-2005) | No | Primary care physician’s information system, Patient self-report | Successful treatment | Intervention is an effective addition to primary care for frail older people at a reasonable cost |
Economic Evaluation of a Multifactorial, Interdisciplinary Intervention Versus Usual Care to Reduce Frailty in Frail Older People (Fairhall et al., 2015) | 70+ years N = 241 Australia | RCT | Multi-factorial inter-disciplinary intervention vs Usual care for frailty | P S | 12 months | Degree of frailty and disability RCT | Health care, Social care, Intervention costs (Australian dollar −2011) | No | Within trial service use database, Literature, Self-report | Transition out of frailty | A 12-month multifactorial intervention provided better value for money than usual care |
Cost effectiveness of a chronic care model for frail older adults in primary care: economic evaluation alongside a stepped-wedge cluster randomised trial (van Leeuwen et al., 2015b) | 65+ years N = 1147 Netherlands | RCT | Geriatric care model vs usual care | S | 24 months | HRQoL (SF-12), and Functional limitations (Katz index) RCT | Health care, Social care, Intervention costs, Informal care (US dollar-2011) | Yes (52%) – Patient diary NM | Participant cost diaries Hospital and pharmacy registries | HRQoL (SF-12) QALY (EQ-5D-3 L) Functional limitations (Katz index) | Geriatric care model was not cost-effective compared to usual care after 24 months of follow-up |
Cost effectiveness of a home-based intervention that helps functionally vulnerable older adults age in place at home (Jutkowitz et al., 2012) | 70+ years 319 USA | RCT | Advancing Better Living for Elders (ABLE) vs Usual care | SP | 2 years | Reduction in functional difficulty and mortality RCT | Intervention costs (US dollar-2010) | No | Within trial database, Literature | Life years saved | Investment in ABLE may be worthwhile depending on society’s willingness to pay |
Cost consequence analysis | |||||||||||
Evidence for the long-term cost effectiveness of home care reablement programs | 10,368 Australia |  | Post discharge reablement (PEP)/Community based reablement (HIP) vs Conventional home care service (HACC) | NM | 5 years | Service provider | Home care service costs | No | WA Department of Health | Utilisation of home care services | Reablement services reduced the need for HACC services and this may contribute to containing the cost of aging |