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Scandinavian Journal of Public Health
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Preventive home visits to older people are cost-effective

Klas-Göran Sahlen

Epidemiology and Public Health, Umeå University, Umeå, Sweden, klasse.sahlen{at}epiph.umu.se, Centre for Population Studies: Ageing and Living Conditions Programme, Umeå University, Umeå, Sweden

Curt Löfgren

Epidemiology and Public Health, Umeå University, Umeå, Sweden

Britt Mari Hellner

IMS, Institute for Evidence-based Social Work Practice, The National Board of Health and Welfare, Stockholm

Lars Lindholm

Epidemiology and Public Health, Umeå University, Umeå, Sweden, Centre for Population Studies: Ageing and Living Conditions Programme, Umeå University, Umeå, Sweden

Aims: There is ongoing debate over the effectiveness of preventive home visits (PHVs) for the elderly. A municipality in the north of Sweden carried out a controlled trial of such visits. Healthy seniors aged 75 years and over received two PHVs per year over 2 years. The aim of this study was to do a cost utility analysis of the intervention. Methods: The intervention group (n=196) was compared with a control group (n=346), and a cost utility analysis was performed. The analysis was carried out with three different time perspectives. Data were sourced from official documents and medical and social records. Results: From a societal perspective, using a time period of 4 years, the analysis of PHVs to healthy seniors showed net savings. When including estimated future costs for health and elderly care during gained life years, the result changed from a net saving to a cost of Euro 200,000. A lifetime perspective also resulted in net savings if the costs of future health and elderly care were not included in the analysis. In this case, the total costs rose to approximately Euro 900,000. The cost could also be expressed as Euro 14,200 per quality-adjusted life year gained if future costs for elderly care and healthcare were included. Conclusions: PHVs represent a cost-effective intervention in this setting. The costs are justified by the outcomes.

Key Words: Community intervention • cost utility analysis • economic evaluation • older people • preventive home visits

Scandinavian Journal of Public Health, Vol. 36, No. 3, 265-271 (2008)
DOI: 10.1177/1403494807086983
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