Modelling the Economic Impact of Reducing Loneliness in Community Dwelling Older People in England

Abstract

Loneliness has been associated with poor mental health and wellbeing. In England, a 2018 national strategy on loneliness was published, and public health guidelines recommend participation in social activities. In the absence of existing economic evidence, we modelled the potential cost effectiveness of a service that connects lonely older people to social activities against no-intervention. A 5-year Markov model was constructed from a health and social care perspective. Parameters were drawn from the literature, with the intervention structure based on an existing loneliness alleviation programme implemented in several settings across England. Univariate and probabilistic sensitivity analyses were undertaken. The total expected cost per participant in the intervention group is £ 7131 compared to £ 6783 in the usual care group with 0.45 loneliness free years (LFY) gained. The incremental cost per LFY gained is £ 768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations. Potentially such interventions may be cost-effective but are unlikely to be cost-saving even allowing for sustained effects and cumulative adverse health and social care events averted. Empirical studies are needed to determine the cost-effectiveness of these interventions, ideally mapping changes in loneliness to the quality of life, in order to allow the key metric in health economic studies, cost per quality adjusted life year to be estimated.

Gender Differences in Correlates of Loneliness among Community-Dwelling Older Koreans

“…Engagement in diverse social activities in later life has been reported to provide opportunities for older adults to exchange similar interests, share life experiences, and facilitate social connections, which may alleviate their loneliness [ 40 , 41 ]. Our findings support previous literature reporting the beneficial effect of social activity on late-life loneliness in both men and women [ 15 , 41 ]. Being married was associated with a lower likelihood of loneliness, but only among men, which is consistent with a Japanese study that showed the increased loneliness risk associated with the absence of a spouse was stronger for men than for women [ 42 ].…”

“…Engagement in various community activities can reduce loneliness in older adults by providing human contact and intimacy [ 8 , 9 , 15 ]. The gerontological literature suggests that social networks and social connections can be important for psychological well-being in later life [ 11 , 16 ].…”

Understanding the Economic Value and Impacts on Informal Carers of People Living with Mental Health Conditions

“…However, we believe our estimate of costs may still be conservative. Loneliness, for example, can be associated with substantial economic costs, due to the increased risk of both physical and mental health problems [ 46 ]. Even though we identified high levels of loneliness in carers, we are not able to put a monetary value on these outcomes, nor can we assume that quality of life captures the impacts of loneliness, or even the stigma that may be associated with caring.…”