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Table 2 Main characteristics of included studies

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

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

  1. Study design: RCT = Randomised Control Trial, QES = Quasi experimental study, Perspective: S=Societal, HS=Health system, PS=Public sector (Health sector and social care sector), SP=Service provider (home care agency), NM = Not mentioned