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Modelling long-term cost-effectiveness of health promotion for community-dwelling older people
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Health and Social Care Administration, Municipality of Östersund, 83182 Östersund, Sweden.ORCID iD: 0000-0002-1087-8656
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-0457-2175
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-1633-2179
Göteborgs universitet.
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2019 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Springer, 2019.
Keywords [en]
Senior meetings, Preventive home visit, QALYs, Booster session, Health economy, Multi-professional
National Category
Occupational Therapy Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Occupational therapy
Identifiers
URN: urn:nbn:se:umu:diva-158632DOI: 10.1007/s10433-019-00505-1OAI: oai:DiVA.org:umu-158632DiVA, id: diva2:1313576
Available from: 2019-05-03 Created: 2019-05-03 Last updated: 2019-05-08

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Zingmark, MagnusNorström, FredrikLindholm, Lars
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