Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial

Suijker, Jacqueline J.; Vroomen, Janet L. MacNeil; Rijn, Marjon van; Buurman, Bianca M.; Rooij, Sophia E. de; Charante, Eric P. Moll van; Bosmans, Judith E.

doi:10.1371/journal.pone.0175272

Cited by 12 publications

(16 citation statements)

References 46 publications

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“…However, there was no trial compared the effects of psychosocial support program and passive therapy directly, meaning that the result that the multi-disciplinary program which included psychosocial support is less potential than psychosocial support program in this network meta-analysis is possible because of the lack of data. Besides, the cost-efficiency of disabled-care programs is always the focus of social concern [ 86 , 87 , 88 ]. However, few studies are comparing the comprehensive cost-efficiency of disabled-care programs.…”

Section: Discussionmentioning

confidence: 99%

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

Sun

et al. 2021

IJERPH

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This systematic review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) guidelines and used the method of network meta-analysis to compare the effects of different types of interventions from different perspectives which were abilities of daily life activity, psychological health, social functioning, and overall life quality. The eligibility criteria were: (1) Participants were adults above 18 years old with disabilities; (2) Interventions could be classified into active exercise, passive therapy, psychological education, psychosocial support program, multi-disciplinary program, and usual care; (3) Outcomes should be the patient-reported outcome measures (PROMs) that could be classified into abilities of daily life activity, psychological health, social functioning, and overall life quality; (4) Randomized designed and published in English. The keywords and their search field were: (1) “people with disabilities/disability”, “disabled”, “handicapped”, or “disable people” in titles or abstracts; (2) AND “randomized” or “randomised” in titles or abstracts; (3) NOT ”design”, “protocol”, or “review” in titles. After searching in databases of Medline (EBSCO), PubMed, CINAHL, and Ovid, 16 studies were included. As a result, active exercise and passive therapy are most likely to be the best interventions for overall life quality, psychological education and passive therapy are most likely to be the best interventions for abilities of daily life activity, and psychosocial support programs are most likely to be the best intervention for psychological health and social functioning.

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Section: Discussionmentioning

confidence: 99%

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

Sun

et al. 2021

IJERPH

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“…The common intervention in preventing frailty of older people usually included physical trainings [14][15][16][17], nutrition assessment [14,15,18], which was performed by dispatched therapist within limited time period. Although this kind of intervention usually provide good effectiveness, the cost-effectiveness regarding cost of medical services was either not taken into account [19] or showed greater cost [20,21]. In HAM, we used telemedicine to reduce the distance barrier between the rural older people and health care providers, thus decreased the cost and provided a sustainable system without time restriction.…”

Section: Telemedicine-based Interventionmentioning

confidence: 99%

Development of the Houston–Apollo model for older people living in remote areas in Taiwan

Chang

Hung

Hsueh

et al. 2021

Geriatrics Gerontology Int

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Background: Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents. Guided by Andersen's Behavior Model, this study examined whether a combined health care system (Houston-Apollo Model, HAM) will improve physical performance and foster medical care utilization of the local population. Methods: People aged ≥ 65 years who participated in congregate meal services (CMS) were recruited. Using concepts of telemedicine and community health records, participants received consultation from local clinics, which provided advices or arranged referral to National Taiwan University Hospital Yunlin Branch (NTUHYL). Physical parameters including blood pressure, body mass index, grip strength, walking speed, and ve-time sit and stand test (FTSST) were recorded and timely transferred to NTUHYL, which in turn result in individualization of intervention strategies. Changes in physical parameters and utilization of healthcare facilities were measured in the beginning of recruitment and one year later to evaluate the effectiveness of the plan. Results: 470 people were recruited. In 1-year follow-up, the mean systolic and diastolic blood pressure (mmHg) decreased from 137.4 to 133.3 (p = 0.019) and from 76.9 to 74.4 (p = 0.008), respectively. The mean time of FTSST (seconds) decreased from 11.3 to 10.4 (p = 0.011). The mean walking speed (m/s) increased from 0.71 to 0.74 (p = 0.039). The rate ratio (95%CI) of medical and dental outpatient clinic usage were 2 (1.1-3.64) and 1.14 (1.06-1.23), respectively. Conclusions: The HAM health care system could bene t the physical status of older adults, promote proactive and preventive health care utilization, and contribute to medical equality.

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“…The majority (n = 25) of the studies were economic evaluations of fall prevention strategies for older people [ 31 – 55 ]. Five studies focussed on problems of general or mobility disability [ 56 – 60 ], two on general health status [ 61 , 62 ], two on lack of physical activity [ 63 , 64 ], one on frailty [ 65 ], one on mental wellbeing [ 66 ] and a further one on oral health [ 67 ]. Regarding the economic evaluation methods used, 29 of the studies were CEAs, two included several natural outcome indicators [cost–consequence analyses (CCA)], and twelve included CUA as well.…”

Section: Main Textmentioning

confidence: 99%

“…Apart from that, one single study mentioned the exclusion of older people’s time or production as a shortcoming of the study [ 62 ]. Two studies argued that productivity losses do not have to be assessed if the study population is predominantly retired [ 45 , 60 ]. For one CBA it can be argued that these indirect costs were implicitly included as part of the valuation of WTP for averted morbidity and mortality [ 52 ].…”

Section: Main Textmentioning

confidence: 99%

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

Hüter

Dubas‐Jakóbczyk

Kocot

et al. 2018

Cost Eff Resour Alloc

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BackgroundIn the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of ‘beyond-health’ benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations.MethodsFollowing a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular.ResultsOf the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard.ConclusionThere is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.Electronic supplementary materialThe online version of this article (10.1186/s12962-018-0100-4) contains supplementary material, which is available to authorized users.

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Cost-effectiveness of nurse-led multifactorial care to prevent or postpone new disabilities in community-living older people: Results of a cluster randomized trial

Cited by 12 publications

References 46 publications

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

Development of the Houston–Apollo model for older people living in remote areas in Taiwan

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

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