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Erschienen in: The European Journal of Health Economics 4/2006

01.12.2006 | Original Papers

Cost effectiveness of preventive home visits to the elderly

Economic evaluation alongside randomized controlled study

verfasst von: Christian Kronborg, Mikkel Vass, Jørgen Lauridsen, Kirsten Avlund

Erschienen in: The European Journal of Health Economics | Ausgabe 4/2006

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Abstract

We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person is able independently to transfer, walk indoors, go outdoors, walk outdoors in both pleasant and poor weather, and climb stairs. In 17 of 34 municipalities health visitors and general practitioners were offered geriatric training, which focused on early signs of disability, physical activity, and interdisciplinary follow-up. The remaining 17 municipalities offered preventive home visits as usual. Outcomes were measured in 4,034 persons aged 75 or 80 years old and dwelling at home. The difference in mean total costs between the intervention and the control group discounted at 3% was €−856 (95% CI −2,455 to 744) in 75-year-olds and €694 (−2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (−0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration.
Literatur
1.
Zurück zum Zitat McNamee P, Gregson BA, Wright K et al. (1998) Estimation of a multiproduct cost function for physically frail older people. Health Econ 7: 701–710CrossRefPubMed McNamee P, Gregson BA, Wright K et al. (1998) Estimation of a multiproduct cost function for physically frail older people. Health Econ 7: 701–710CrossRefPubMed
2.
Zurück zum Zitat Stuck AE, Egger M, Hammer A et al. (2002) Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 287: 1022–1028CrossRefPubMed Stuck AE, Egger M, Hammer A et al. (2002) Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 287: 1022–1028CrossRefPubMed
3.
Zurück zum Zitat Elkan R, Kendrick D, Dewey M et al. (2001) Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ 323: 719–725CrossRefPubMed Elkan R, Kendrick D, Dewey M et al. (2001) Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ 323: 719–725CrossRefPubMed
4.
Zurück zum Zitat Vass M, Avlund K, Hendriksen C et al. (2002) Preventive home visits to older people in Denmark: methodology of a randomized controlled study. Aging Clin Exp Res 14: 509–515PubMed Vass M, Avlund K, Hendriksen C et al. (2002) Preventive home visits to older people in Denmark: methodology of a randomized controlled study. Aging Clin Exp Res 14: 509–515PubMed
5.
Zurück zum Zitat Vass M, Avlund K, Kvist K et al. (2004) Structured home visits to older people. Are they only of benefit for women? A randomised controlled trial. Scand J Prim Health Care 22: 106–111CrossRefPubMed Vass M, Avlund K, Kvist K et al. (2004) Structured home visits to older people. Are they only of benefit for women? A randomised controlled trial. Scand J Prim Health Care 22: 106–111CrossRefPubMed
6.
Zurück zum Zitat Ministy of Health (2001) Takstsystem 2002 – vejledning [Hospital charges 2002 (in Danish)]. Copenhagen: Sundhedsministeriet Ministy of Health (2001) Takstsystem 2002 – vejledning [Hospital charges 2002 (in Danish)]. Copenhagen: Sundhedsministeriet
7.
Zurück zum Zitat Brouwer WB, Rutten F, Koopmanschap M (2001) Costing in economic evaluations. In: Drummond M, McGuire A (eds) Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press Brouwer WB, Rutten F, Koopmanschap M (2001) Costing in economic evaluations. In: Drummond M, McGuire A (eds) Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press
8.
Zurück zum Zitat National Board of Health (2005) Takstsystem 2005 – Vejledning [Hospital charges 2005 (in Danish)]. Copenhagen: Sundhedsstyrelsen National Board of Health (2005) Takstsystem 2005 – Vejledning [Hospital charges 2005 (in Danish)]. Copenhagen: Sundhedsstyrelsen
9.
Zurück zum Zitat The National Health Insurance Service (2002) Den offentlige sygesikring. Sygesikringens administrative vejledning – takster [The National Health Insurance Service—Charges (in Danish)]. Copenhagen The National Health Insurance Service (2002) Den offentlige sygesikring. Sygesikringens administrative vejledning – takster [The National Health Insurance Service—Charges (in Danish)]. Copenhagen
10.
Zurück zum Zitat Dranove D (1996) Measuring costs. In: Sloan FA (ed) Valuing health care. Costs, benefits, and effectiveness of pharmaceuticals and other medical technologies. Cambridge: Cambridge University Press, pp 61–76 Dranove D (1996) Measuring costs. In: Sloan FA (ed) Valuing health care. Costs, benefits, and effectiveness of pharmaceuticals and other medical technologies. Cambridge: Cambridge University Press, pp 61–76
12.
Zurück zum Zitat Kommunernes Landsforening (2001) Tal på tid – tale om tid. Standard for tidsregistrering i hjemmeplejen [Standard for registration of time use in community care. (in Danish)]. Copenhagen: Kommunernes Landsforenings Forlag Kommunernes Landsforening (2001) Tal på tid – tale om tid. Standard for tidsregistrering i hjemmeplejen [Standard for registration of time use in community care. (in Danish)]. Copenhagen: Kommunernes Landsforenings Forlag
13.
Zurück zum Zitat Kommunernes Landsforening (2003) Frit valg og kvalitet – afregingsmodeller på de kommunale serviceområder. Copenhagen: Finansministeriet Kommunernes Landsforening (2003) Frit valg og kvalitet – afregingsmodeller på de kommunale serviceområder. Copenhagen: Finansministeriet
14.
Zurück zum Zitat Drummond MF, O’Brien B, Stoddart GL, Torrance GW (1997) Methods for the economic evaluation of health care programmes, 2 edn. Oxford: Oxford University Press Drummond MF, O’Brien B, Stoddart GL, Torrance GW (1997) Methods for the economic evaluation of health care programmes, 2 edn. Oxford: Oxford University Press
15.
Zurück zum Zitat Avlund K, Kreiner S, Schultz-Larsen K (1996) Functional ability scales for the elderly. A validation study. Eur J Public Health 6: 35–42CrossRef Avlund K, Kreiner S, Schultz-Larsen K (1996) Functional ability scales for the elderly. A validation study. Eur J Public Health 6: 35–42CrossRef
16.
Zurück zum Zitat Avlund K, Thudium D, Davidsen M, Fuglsang-Sørensen B (1995) Are self-ratings of functional ability reliable. Scand J Public Health 12: 10–16 Avlund K, Thudium D, Davidsen M, Fuglsang-Sørensen B (1995) Are self-ratings of functional ability reliable. Scand J Public Health 12: 10–16
17.
Zurück zum Zitat Kerry SM, Bland JM (1998) Trials which randomize practices. I How should they be analysed? Fam Pract 15: 80–83CrossRefPubMed Kerry SM, Bland JM (1998) Trials which randomize practices. I How should they be analysed? Fam Pract 15: 80–83CrossRefPubMed
18.
Zurück zum Zitat Briggs AH (2001) Handling uncertainty in economic evaluation and presenting results. In: Drummond M, McGuire A (eds) Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press Briggs AH (2001) Handling uncertainty in economic evaluation and presenting results. In: Drummond M, McGuire A (eds) Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press
19.
Zurück zum Zitat Gyrd-Hansen D, Holund B, Andersen P (1995) A cost-effectiveness analysis of cervical cancer screening: health policy implications. Health Policy 34: 35–51CrossRefPubMed Gyrd-Hansen D, Holund B, Andersen P (1995) A cost-effectiveness analysis of cervical cancer screening: health policy implications. Health Policy 34: 35–51CrossRefPubMed
20.
Zurück zum Zitat Gyrd-Hansen D (1997) Is it cost effective to introduce screening programmes for colorectal cancer? Illustrating the principles of optimal resource allocation. Health Policy 41: 189–199CrossRefPubMed Gyrd-Hansen D (1997) Is it cost effective to introduce screening programmes for colorectal cancer? Illustrating the principles of optimal resource allocation. Health Policy 41: 189–199CrossRefPubMed
21.
Zurück zum Zitat Gyrd-Hansen D (1998) Modelling the cost-effectiveness of cancer screening in Denmark. Applications and issues of methodology. Thesis, Odense University Gyrd-Hansen D (1998) Modelling the cost-effectiveness of cancer screening in Denmark. Applications and issues of methodology. Thesis, Odense University
22.
Zurück zum Zitat Andersen TF, Madsen M, Jorgensen J et al. (1999) The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 46: 263–268PubMed Andersen TF, Madsen M, Jorgensen J et al. (1999) The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 46: 263–268PubMed
23.
Zurück zum Zitat Olivarius NF, Hollnagel H, Krasnik A et al. (1997) The Danish National Health Service Register. A tool for primary health care research. Dan Med Bull 44: 449–453PubMed Olivarius NF, Hollnagel H, Krasnik A et al. (1997) The Danish National Health Service Register. A tool for primary health care research. Dan Med Bull 44: 449–453PubMed
24.
Zurück zum Zitat Gaist D, Sorensen HT, Hallas J (1997) The Danish prescription registries. Dan Med Bull 44: 445–448PubMed Gaist D, Sorensen HT, Hallas J (1997) The Danish prescription registries. Dan Med Bull 44: 445–448PubMed
25.
Zurück zum Zitat Hallas J (2001) Conducting pharmacoepidemiologic research in Denmark. Pharmacoepidemiol Drug Saf 10: 619–623CrossRefPubMed Hallas J (2001) Conducting pharmacoepidemiologic research in Denmark. Pharmacoepidemiol Drug Saf 10: 619–623CrossRefPubMed
26.
Zurück zum Zitat Luce B, Manning W, Siegel J, Lipscomb J (1996) Estimating costs in cost-effectiveness analysis. In: Gold MR, Siegel JE, Russel LB, Weinstein MC (eds) Cost-effectiveness in health and medicine. Oxford: Oxford University Press, pp 176–213 Luce B, Manning W, Siegel J, Lipscomb J (1996) Estimating costs in cost-effectiveness analysis. In: Gold MR, Siegel JE, Russel LB, Weinstein MC (eds) Cost-effectiveness in health and medicine. Oxford: Oxford University Press, pp 176–213
27.
Zurück zum Zitat Brouwer WB, van Exel NJ, Koopmanschap MA, Rutten FF (1999) The valuation of informal care in economic appraisal. A consideration of individual choice and societal costs of time. Int J Technol Assess Health Care 15: 147–160CrossRefPubMed Brouwer WB, van Exel NJ, Koopmanschap MA, Rutten FF (1999) The valuation of informal care in economic appraisal. A consideration of individual choice and societal costs of time. Int J Technol Assess Health Care 15: 147–160CrossRefPubMed
28.
Zurück zum Zitat Richardson G, Manca A (2004) Calculation of quality adjusted life years in the published literature: a review of methodology and transparency. Health Econ 13: 1203–1210CrossRefPubMed Richardson G, Manca A (2004) Calculation of quality adjusted life years in the published literature: a review of methodology and transparency. Health Econ 13: 1203–1210CrossRefPubMed
29.
Zurück zum Zitat Robertson MC, Gardner MM, Devlin N et al. (2001) Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. II. Controlled trial in multiple centres. BMJ 322: 701–704CrossRefPubMed Robertson MC, Gardner MM, Devlin N et al. (2001) Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. II. Controlled trial in multiple centres. BMJ 322: 701–704CrossRefPubMed
30.
Zurück zum Zitat Robertson MC, Devlin N, Gardner MM, Campbell AJ (2001) Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. I. Randomised controlled trial. BMJ 322: 697–701CrossRefPubMed Robertson MC, Devlin N, Gardner MM, Campbell AJ (2001) Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. I. Randomised controlled trial. BMJ 322: 697–701CrossRefPubMed
31.
Zurück zum Zitat Smith RD, Widiatmoko D (1998) The cost-effectiveness of home assessment and modification to reduce falls in the elderly. Aust N Z J Public Health 22: 436–440PubMed Smith RD, Widiatmoko D (1998) The cost-effectiveness of home assessment and modification to reduce falls in the elderly. Aust N Z J Public Health 22: 436–440PubMed
32.
Zurück zum Zitat Rizzo JA, Baker DI, McAvay G, Tinetti ME (1996) The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care 34: 954–869CrossRefPubMed Rizzo JA, Baker DI, McAvay G, Tinetti ME (1996) The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care 34: 954–869CrossRefPubMed
33.
Zurück zum Zitat Rossum E van, Frederiks CM, Philipsen H et al. (1993) Effects of preventive home visits to elderly people. BMJ 307: 27–32PubMed Rossum E van, Frederiks CM, Philipsen H et al. (1993) Effects of preventive home visits to elderly people. BMJ 307: 27–32PubMed
Metadaten
Titel
Cost effectiveness of preventive home visits to the elderly
Economic evaluation alongside randomized controlled study
verfasst von
Christian Kronborg
Mikkel Vass
Jørgen Lauridsen
Kirsten Avlund
Publikationsdatum
01.12.2006
Verlag
Springer-Verlag
Erschienen in
The European Journal of Health Economics / Ausgabe 4/2006
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-006-0361-2

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