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Randomized Controlled Trial
. 2020 Jul 13;75(8):1586-1593.
doi: 10.1093/gerona/glz139.

The Effects of Preventive Home Visits on Older People's Use of Health Care and Social Services and Related Costs

Heini A Liimatta  1   2 , Pekka Lampela  1 , Hannu Kautiainen  2   3 , Pirjo Laitinen-Parkkonen  4 , Kaisu H Pitkala  2   3
Affiliations
Randomized Controlled Trial

The Effects of Preventive Home Visits on Older People's Use of Health Care and Social Services and Related Costs

Heini A Liimatta et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: We use data from a randomized controlled trial on preventive home visits exploring effectiveness on health-related quality of life. In this article, we examine the intervention's cost-effectiveness and effects on quality-adjusted life years in older home-dwelling adults.

Methods: There were 422 independently home-dwelling participants in the randomized, controlled trial, all aged more than 75 years, with equal numbers in the control and intervention groups. The intervention took place in a municipality in Finland and consisted of multiprofessional preventive home visits. We gathered the data on health care and social services use from central registers and medical records during 1 year before the intervention and 2 years after the intervention. We analyzed the total health care and social services use and costs per person-years and the difference in change in health-related quality of life as measured using the 15D measure. We calculated quality-adjusted life years and incremental cost-effectiveness ratios.

Results: There was no significant difference in baseline use of services or in the total use and costs of health care and social services during the 2-year follow-up between the two groups. In the intervention group, health-related quality of life declined significantly more slowly compared with the control group (-0.015), but there was no significant difference in quality-adjusted life years gained between the groups. The cost-effectiveness plane showed 60% of incremental cost-effectiveness ratios lying in the dominant quadrant, representing additional effects with lower costs.

Conclusions: This multiprofessional preventive home visit intervention appears to have positive effects on health-related quality of life without accruing additional costs.

The clinical trial registration number: ACTRN12616001411437.

Keywords: Cost effectiveness; Geriatric assessment; Health services; Preventative health care; Primary care.

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