Effects of preventive home visits on health care costs for ambulatory frail elders: a randomized controlled trial

Abstract

Background and aimsReducing health care costs through preventive geriatric care has become a high priority in Japan. We analyzed data from a randomized controlled trial to examine the effects of a preventive home visit program on health care costs among ambulatory frail elders.MethodsStructured preventive home visits by nurses or care managers were provided to the visit group every 6 months over 2 years. The enrolled participants (N = 323) were randomly assigned to either the visit group (N = 161) or the control group (N = 162). We analyzed the health care costs, including the costs for hospitalizations and outpatient clinic utilization for participants who had health care insurance from the local government (N = 307). The visit group included 154 individuals in the visit group and 153 people in the control group.ResultsTotal health care costs over the study period were not significantly different between groups, but at most monthly time points costs and those for outpatient clinic utilization in the visit group were lower than those in the control group. Hospitalizations, which accounted for more than ¥500,000 JPY per month, were less likely to occur more often among participants in the visit group (N = 71) than in the control group (N = 113) (OR = 0.63; p = 0.002).ConclusionsThese results suggest that a preventive home visit program may reduce monthly health care costs, primarily by reducing hospitalization costs.

Impact of the Community-Based Active Monitoring Program on the Long Term Care Services Use and In-Patient Admissions of the Over-74 Population

“…The role played by the informal actors in the network and the capacity of the program of networking formal and informal individuals and private/public bodies represent the added value of the program. CAMP allows relevant cost saving by managing the demand of care; Kono et al stated something similar in an interesting randomized controlled trial published in 2013 [33]. The cost saving was correlated to both the decreased number of hospitalization and the use of outpatient care.…”

Nurses’ competencies in health promotion for homebound older people

“…Kono et al (17) , The average costs of health care during the study's 2-year period decreased slightly in the group who had received home visits as compared to the CG, but the difference was not significant. For most months, financial costs in the IG were lower than in the CG; considering the 2-year period, both groups had similar average costs of hospital care.…”

“…Promote empowerment (15)(16)(18)(19)(22)(23) Promote health education (18) Facilitate the development of skills (18,23) Professional training (21) Advocate for Health Improve health (23) Enable therapeutic adherence (23) Facilitate access to community assets (20) Enable cost reduction (17) Influence stakeholders for change (19,21,23) Raise awareness on health issues (19) Stimulus for the use of social resources (19) Mediate through Partnership…”

Assessing the quality and effectiveness of an updated preventive home visit programme for ambulatory frail older Japanese people: research protocol for a randomized controlled trial

“…), including our studies (Kono et al . , , ), functional status differed between the older adult participants in each trial and hence more evidence needs to be generated in our care setting. Our PHV studies (Kono et al .…”

“…Our PHV studies (Kono et al . , , ) have targeted ambulatory frail community‐dwelling elders, because they risk further decline in physical function (Kono et al . , ) and have preventive care needs that they have not yet recognized themselves.…”