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

Journal article
Authors Magnus Zingmark
Fredrik Norström
Lars Lindholm
Synneve Dahlin-Ivanoff
Susanne Gustafsson
Published in European Journal of Ageing
Volume 16
Issue 4
Pages 395–404
ISSN 1613-9372
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Centre for Ageing and Health (Agecap)
Pages 395–404
Language en
Keywords Booster session, Health economy, Multi-professional, Preventive home visit, QALYs, Senior meetings
Subject categories Occupational Therapy


© 2019, The Author(s). 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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