Effects of preventive home visits on older people's use and costs of health care services: A systematic review

Abstract

H. (2016) Effects of preventive home visits on older people's use and costs of health care services: A systematic review. European Geriatric Medicine, 7(6), 571-580. Sammendrag:Introduction: The aim of this study was to systematically review the evidence from randomized controlled trials (RCT) concerning effectiveness of preventive home visit (PHV) programs on older people's use and costs of health and social services. We also evaluated resultant costs-changes achieved with intervention in older people's functioning, quality-oflife (QOL) or mortality. Materials and methods: A systematic review of published RCTs reporting use and/or costs on PHVs on multimorbid older people was performed. The characteristics and methodological quality of studies were assessed. Results: Of the 3219 articles screened, 19 met the inclusion criteria. The methodological quality of the trials was principally moderate (n = 5) or good (n = 10). Of the studies, 12 evaluated the overall costs of health and social services. None of these studies was able to show significant differences in total costs between intervention and control groups. Six studies suggested that PHVs may decrease nursing home admissions and/or hospital days. Seven studies showed some favorable effect on physical functioning, QOL, or mortality, without increasing the total health care costs. Conclusions: Of the high number of studies investigating efficacy of PHVs on older people, only a few studies explore economic effects. PHVs do not provide overall savings to health care costs, but some interventions might offer some cost-neutral positive effects on functioning, QOL and/or mortality. More studies are needed to clarify the effective aspects of the programs and cost-effectiveness of the PHVs.Omsorgsbiblioteket har ikke tilgang til å publisere dette dokumentet i fulltekst. Kanskje ditt lokale bibliotek kan hjelpe deg, eller kanskje du kommer videre med lenken nedenfor.

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

“…15 However, it is currently unclear which intervention components are most beneficial for older people with frailty. 16,17 Home-based interventions appear to be promising, with evidence suggesting that they can have beneficial effects on mortality, functioning and emergency department admissions, with neutral effects on costs. [16][17][18][19] Previous evidence supported interventions based on multidimensional geriatric assessment including follow-up visits.…”

“…16,17 Home-based interventions appear to be promising, with evidence suggesting that they can have beneficial effects on mortality, functioning and emergency department admissions, with neutral effects on costs. [16][17][18][19] Previous evidence supported interventions based on multidimensional geriatric assessment including follow-up visits. 15 However, this type of intervention, typically with involvement from a multidisciplinary team of health and social care professionals, is expensive and difficult to deliver at scale, particularly if targeted at the larger group of up to 41% of older people with mild or pre-frailty living at home.…”

Preventive home visits to promote the health-related quality of life of home-dwelling older people: Baseline findings and feasibility of a randomized, controlled trial

“…Therefore, preventive and proactive interventions supporting older people's health, functioning and well-being are needed. Preventive home visits (PHVs) for older people have been suggested as a means to enhance these goals, but the data on their effectiveness and cost-effectiveness are controversial [1,2].…”

“…Although there is a high number of trials exploring efficacy of PHVs [1], they are not easily comparable because of varying interventions, differing populations [2] and insufficient reporting and poor compliance [1,[3][4][5].…”

Yonder: Obese young people, fertility education, carers, and home visits

“…A Finnish research team recently completed a systematic review of randomised controlled trials reporting use and/or costs of home visits on older people with multimorbidities. 4 Although six studies suggested that they may decrease nursing home admissions and/or hospital days, and seven studies showed some favourable effect on quality of life or mortality, no studies were able to show significant differences in total costs between intervention and control groups.…”