OPEN IN READ APP
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Reducing disability in community-dwelling frail older people: cost-effectiveness study alongside a cluster randomised controlled trial

Silke F Metzelthin, Erik van Rossum, Marike R C Hendriks, Luc P De Witte, Sjoerd O Hobma, Walther Sipers, Gertrudis I J M Kempen
Age and Ageing 2015, 44 (3): 390-6
25566783

BACKGROUND: although proactive primary care, including early detection and treatment of community-dwelling frail older people, is a part of the national healthcare policy in several countries, little is known about its cost-effectiveness.

OBJECTIVE: to evaluate the cost-effectiveness of a proactive primary care approach in community-dwelling frail older people.

DESIGN AND SETTING: embedded in a cluster randomised trial among 12 Dutch general practitioner practices, an economic evaluation was performed from a societal perspective with a time horizon of 24 months.

METHOD: frail older people in the intervention group received an in-home assessment and interdisciplinary care based on a tailor-made treatment plan and regular evaluation and follow-up. Practices in the control group delivered usual care. The primary outcome for the cost-effectiveness and cost-utility analysis was disability and health-related quality of life, respectively.

RESULTS: multilevel analyses among 346 frail older people showed no significant differences between the groups regarding disability and health-related quality of life at 24 months. People in the intervention group used, as expected, more primary care services, but there was no decline in more expensive hospital and long-term care. Total costs over 24 months tended to be higher in the intervention group than in the control group (€26,503 versus €20,550, P = 0.08).

CONCLUSIONS: the intervention under study led to an increase in healthcare utilisation and related costs without providing any beneficial effects. This study adds to the scarce amount of evidence of the cost-effectiveness of proactive primary care in community-dwelling frail older people.

TRIAL REGISTRATION: Current Controlled Trials, ISRCTN 31954692.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
25566783
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"