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Cost‐Effectiveness of Preventive Occupational Therapy for Independent‐Living Older Adults
Author(s) -
Hay Joel,
LaBree Laurie,
Luo Roger,
Clark Florence,
Carlson Mike,
Mandel Deborah,
Zemke Ruth,
Jackson Jeanne,
Azen Stanley P.
Publication year - 2002
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2002.50359.x
Subject(s) - medicine , randomized controlled trial , quality adjusted life year , quality of life (healthcare) , confidence interval , cost effectiveness , physical therapy , gerontology , surgery , nursing , risk analysis (engineering)
OBJECTIVES: To evaluate the cost‐effectiveness of a 9‐month preventive occupational therapy (OT) program in the Well‐Elderly Study: a randomized trial in independent‐living older adults that found significant health, function, and quality of life benefits attributable to preventive OT. DESIGN: A randomized trial. SETTING: Two government‐subsidized apartment complexes. PARTICIPANTS: One hundred sixty‐three culturally diverse volunteers aged 60 and older. INTERVENTION: An OT group, a social activity group (active control), and a nontreatment group (passive control). MEASUREMENTS: Use of healthcare services was determined by telephone interview during and after the treatment phase. A conversion algorithm was applied to the RAND 36‐item Short Form Health Survey to derive a preference‐based health‐related quality of life index, quality‐adjusted life years (QALYs), and the incremental cost‐effectiveness ratio for preventive OT relative to the combined control group. RESULTS: Costs for the 9‐month OT program averaged $548 per subject. Postintervention healthcare costs were lower for the OT group ($967) than for the active control group ($1,726), the passive control group ($3,334), or a combination of the control groups ($2,593). The quality of life index showed a 4.5% QALY differential (OT vs combined control), P < .001. The cost per QALY estimates for the OT group was $10,666 (95% confidence interval = $6,747–$25,430). For the passive and active control groups, the corresponding costs per QALY were $13,784 and $7,820, respectively. CONCLUSION: In this study, preventive OT demonstrated cost‐effectiveness in conjunction with a trend toward decreased medical expenditures.