Some gain for a small investment: An economic evaluation of an exercise program for people living in residential aged care

Abstract

Objective: To evaluate the cost-effectiveness of a 12-week Exercise Physiology (EP) program for people living in a residential aged care facility. Methods: A within-study pre-and postintervention design to calculate incremental cost-effectiveness ratios per quality-adjusted life years gained. A health service provider perspective was used. Results: Fifty-nine participants enrolled in a 12-week program. The program cost was A$514.30 per resident. At a willingness-to-pay threshold of A$64 000, the likelihood of being cost-effective of the program is approximately 60%, due to a small increase in participants' quality of life, as reported by care staff. The model showed great variance, depending on who rated the participants' quality of life outcomes. Conclusion:It is uncertain that a 12-week EP program is cost-effective based on the evidence of the current trial. However, it appears that a low-cost program can produce small improvements for residents in care facilities. K E Y W O R D Scognitive decline, economic evaluation, exercise program, physical function, residential aged care | INTRODUCTIONResidential aged care facilities (RACF) provide care to older people who can no longer continue living independently and safely in their homes. Over 200 000 people live in RACF in Australia, and up to 80% experience a level of cognitive impairment, 1 and approximately 52% have a formal diagnosis of dementia. 2,3 In 2016, the average total yearly cost of dementia (after first year) for a person living in RACF was A$23 810. 3 The type and level of care that is provided in RACF varies from assistance to perform activities of daily living to nursing care, reflecting the needs of each resident. 4 Access to specialised care such as exercise or other allied health professionals is available in many facilities in order to maintain or promote physical and mental health, functional independence and foster social engagement between the residents. 5 Exercise can support healthy ageing 6 and improve cognitive and functional capacity of people with cognitive decline. [7][8][9] Recent years have seen a push to include exercise programs in RACF as they have the potential to improve cognition, mood, mobility and functional ability for residents, including people with cognitive impairment. 8,10 With likely comorbidities, [Correction added on 7th November, after first online publication: Dannielle Post's name has been corrected.]

Cost-effectiveness of physical activity programs and services for older adults: a scoping review

“…Most studies recruited older adults living in the community ( n = 23), one investigated older adults living both in care facilities and community [ 41 ] and three studies recruited participants from care facilities [ 36 , 38 , 49 ]. Only eight CUA studies investigated participants selected for pre-existing conditions: intermittent claudication [ 53 ], vascular cognitive impairment [ 40 ], post-hip fracture [ 49 ], cancer [ 50 , 54 ], vertebral compression fracture [ 52 ] and chronic obstructive pulmonary disease [ 55 ] and Parkinson’s [ 51 ].…”