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Results for 'cost effectiveness'

Results 1 - 10 of 61

Prevention: wrestling with new economic realities

KNAPP Martin
2013

Purpose : The purpose of this paper is to discuss the economic pressures on long-term care systems, and describe how an economic case might be made for better care, support and preventive strategies. Design/methodology/approach: Discussion of recent developments and research responses, with illustrations from previous studies. Findings: Economics evidence is highly relevant to decision makers in health, social care, and related systems. When resources are especially tight, economics evidence can sometimes persuade uncertain commissioners and others to adopt courses of action that improve the wellbeing of individuals, families, and communities. Originality/value: The paper uses long-established approaches in economic evaluation to discuss preventive and other strategies in today's challenging context.

WRVS: delivering the preventative social care agenda

BERRY Lynne
2010

This article starts by outlining the importance of increased prevention investment and produces a series of evidence that emphasises how preventative approaches improve the quality of life of older people, whilst providing value for money. It describes prevention in this context as: giving older people respect for who they are; giving older people the feeling they are in control; having people older people trust around them; and giving older people the help they want, when they need it. After providing simple statistics outlining the success, this article moves on to illustrate, through personal stories, how the work of the Women's Royal Voluntary Service (WRVS) sits at the heart of delivering the preventative social care agenda. The paper ends by putting out a question for debate: what will the entitlement to preventative support mean in practice in a reformed social care system?

Preventive social care: is it cost effective?

CURRY Natasha
2006

This paper attempts to pull together and review key pieces of evidence about the cost effectiveness of prevention. The findings, which reflect a paucity of quantified information about the effectiveness of preventive interventions, suggest that there is a strong financial case for reducing hospitalisation (particularly through falls) and for reducing the rate of institutionalisation by maintaining independence. Small-scale trials show that small interventions could prevent falls and reduce the rate of institutionalisation. However, establishing a direct causal relationship between such interventions and long-term financial savings has proved problematic although. There is a lack of consensus over the cost effectiveness of intermediate care although there is evidence that it is cost effective when targeting specific groups/illnesses/events such as stroke and falls. Evidence for secondary stroke prevention services is perhaps the strongest, and most widely quantified, body of research. There is some evidence that primary prevention strategies (such as smoking cessation and reduced salt intake) have potential to reduce the incidence of stroke. The paper makes a series of recommendations, calling for a greater focus on low-level interventions, particularly where there is qualitative evidence that they are valued by service users; implementation of promising interventions, even if not supported by robust evidence, accompanying by formal evaluation during roll-out; development of standard outcome measures of prevention; targeting resources to ensure greatest impact; and greater integration between health and social care services as a drive to shift services towards the preventive end of the spectrum.

Hospital to a Healthier Home: evaluation of a winter pressures pilot service

CARE AND REPAIR CYMRU
2019

An evaluation of the Hospital to a Healthier Home pilot scheme, delivered by Care and Repair, which ran from 11 hospitals between January and March 2019. The scheme aimed to support older people to be safely and more quickly discharged from hospitals to their homes and prevent them being re-admitted by making their homes safe and more accessible. This evaluation describes how the Hospital to a Health Home case worker service started, what type of interventions have been provided to patients and hospital staff, costs, benefits and the difference it has made to patient well-being, quicker safe discharges, and preventing re-admissions. The pilot involved dedicated Care and Repair case workers based at each hospital to facilitate practical improvements to a patient’s home and offer practical support on issues such as benefits entitlements. During the evaluation period: 626 patients were referred through Hospital to a Healthier Home service; 508 patients received work that helped quicker safe discharge. Based on a local assessment of bed day savings, the evaluation found that service costs are fully substantiated, and return £2.80 for every £1 invested (both revenue and capital). NHS frontline staff interviewed for the evaluation study also felt the service was of significant benefit and had the potential to deliver more.

Dance to Health 'Phase 1 roll-out [test and learn]' evaluation: first report

SHEFFIELD HALLAM UNIVERSITY. Sport Industry Research Centre
2019

An evaluation of the Dance to Health falls prevention dance programme. The evaluation investigates whether Dance to Health is an effective and cost-effective way to address older people’s falls and whether the programme helps older people in danger of falling overcome lost confidence, reduced independence and increased isolation. The evaluation used a mixed methods approach that included quantitative, qualitative and econometric research. Primary outcome measures included the impact on falls, positive side-effects (mentally and physically), patient pull, attendance and adherence, fidelity to existing falls prevention programmes and cost effectiveness. The findings show that Dance to Health is helping older people in danger of falling overcome lost confidence, reduced independence and increased isolation. There was a 44 percent reduction in the number of falls, positive improvements in participants' physical and mental wellbeing, including improved Timed Up and Go (TUG) times and reduced fear of falling. Additionally, based on the analysis conducted, there is a potential cost saving of over £149m over a 2-year period, of which £120m is a potential cost saving for the NHS. Dance to Health's fidelity to existing physiotherapy programmes was also confirmed. The evidence suggests that Dance to Health offers the health system a more effective and cost-effective means to address the issue of older people's falls.

It’s time for Local Area Coordination

COMMUNITY CATALYSTS
2019

The report provides information on the Local Area Coordination and highlights the positive impact it has had on communities in England and Wales. Drawing on the experience of the 11 current members of the Local Area Coordination Network, who are local authorities or health services, the report shares stories to show how the model can: make local communities better places to live; improve the health and wellbeing of local people; integrate health and social care; co-produce change with local people; reform the front door to services; and create social value and reduce costs.

An evaluation of Wolverhampton's social prescribing service: a new route to wellbeing

MASSIE Rachel, AHMAD Nahid
2019

An independent evaluation of Wolverhampton social prescribing pilot service, which was launched in 2017 by the Clinical Commissioning Group in collaboration with Wolverhampton Voluntary Sector Council. The evaluation found that the service, which provides a link between primary care services and voluntary and community organisations for those with non-clinical issues, is highly regarded. A total of 676 referrals were received between May 2017 and December 2018. The most common reasons for referral were loneliness and low-level mental health conditions. Link workers made onward referrals to over 150 groups and services. Participants reported a positive impact on mental health, wellbeing, confidence, self-esteem, and even physical health for those who had been referred. The report estimates that Return on Investment means that for every £1 spent on the social prescribing intervention, there will be a saving of £0.15 for primary care services. The researchers recommended further awareness-raising activities, quarterly progress reports and better communication to service users around the nature of the service and wider access, as well as improved data capture.

Are acceptance and mindfulness‐based interventions ‘value for money’? Evidence from a systematic literature review

DUARTE Rui, et al
2019

Objectives: Acceptance and mindfulness‐based interventions (A/MBIs) are recommended for people with mental health conditions. Although there is a growing evidence base supporting the effectiveness of different A/MBIs for mental health conditions, the economic case for these interventions has not been fully explored. The aim of this systematic review was to identify and appraise all available economic evidence of A/MBIs for the management of mental health conditions. Methods: Eight electronic bibliographic databases (MEDLINE, MEDLINE In‐Process & Other Non‐Indexed Citations, EMBASE, Web of Science, NHS Economic Evaluation Database (EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) database, and EconLit) were searched for relevant economic evaluations published from each database's inception date until November 2017. Study selection, quality assessment, and data extraction were carried out according to published guidelines. Results: Ten relevant economic evaluations presented in 11 papers were identified. Seven of the included studies were full economic evaluations (i.e., costs and effects assessed), and three studies were partial economic evaluations (i.e., only costs were considered in the analysis). The A/MBIs that had been subjected to economic evaluation were acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT), mindfulness‐based cognitive therapy (MBCT), and mindfulness‐based stress reduction (MBSR). In terms of clinical presentations, the evaluation of cost‐effectiveness of A/MBIs has been more focused on depression and emotional unstable personality disorder with three and four economic evaluations, respectively. Three out of seven full economic evaluations observed that A/MBIs were cost‐effective for the management of mental health conditions. Nevertheless, the heterogeneity of included populations, interventions, and economic evaluation study types limits the extent to which firm conclusions can currently be made. Conclusion: This first substantive review of economic evaluations of A/MBIs indicates that more research is needed before firm conclusions can be reached on the cost‐effectiveness of A/MBIs for mental health conditions.

The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: a systematic review

LOOMAN Wilhelmina Mijntje, HUIJSMAN Robbert, FABBRICOTTI Isabelle Natalina
2019

Integrated care is increasingly promoted as an effective and cost‐effective way to organise care for community‐dwelling frail older people with complex problems but the question remains whether high expectations are justified. Our study aims to systematically review the empirical evidence for the effectiveness and cost‐effectiveness of preventive, integrated care for community‐dwelling frail older people and close attention is paid to the elements and levels of integration of the interventions. We searched nine databases for eligible studies until May 2016 with a comparison group and reporting at least one outcome regarding effectiveness or cost‐effectiveness. We identified 2,998 unique records and, after exclusions, selected 46 studies on 29 interventions. We assessed the quality of the included studies with the Effective Practice and Organization of Care risk‐of‐bias tool. The interventions were described following Rainbow Model of Integrated Care framework by Valentijn. Our systematic review reveals that the majority of the reported outcomes in the studies on preventive, integrated care show no effects. In terms of health outcomes, effectiveness is demonstrated most often for seldom‐reported outcomes such as well‐being. Outcomes regarding informal caregivers and professionals are rarely considered and negligible. Most promising are the care process outcomes that did improve for preventive, integrated care interventions as compared to usual care. Healthcare utilisation was the most reported outcome but we found mixed results. Evidence for cost‐effectiveness is limited. High expectations should be tempered given this limited and fragmented evidence for the effectiveness and cost‐effectiveness of preventive, integrated care for frail older people. Future research should focus on unravelling the heterogeneity of frailty and on exploring what outcomes among frail older people may realistically be expected.

Economic evaluations of falls prevention programs for older adults: a systematic review

OLIJ Branko F., et al
2018

Objectives: To provide a comprehensive overview of economic evaluations of falls prevention programs and to evaluate the methodology and quality of these studies. Design: Systematic review of economic evaluations on falls prevention programs. Setting: Studies (N=31) of community‐dwelling older adults (n=25), of older adults living in residential care facilities (n=3), and of both populations (n=3) published before May 2017. Participants: Adults aged 60 and older. Measurements: Information on study characteristics and health economics was collected. Study quality was appraised using the 20‐item Consensus on Health Economic Criteria. Results: Economic evaluations of falls prevention through exercise (n = 9), home assessment (n = 6), medication adjustment (n = 4), multifactorial programs (n = 11), and various other programs (n = 13) were identified. Approximately two‐thirds of all reported incremental cost‐effectiveness ratios (ICERs) with quality‐adjusted life‐years (QALYs) as outcome were below the willingness‐to‐pay threshold of $50,000 per QALY. All studies on home assessment and medication adjustment programs reported favorable ICERs, whereas the results of studies on exercise and multifactorial programs were inconsistent. The overall methodological quality of the studies was good, although there was variation between studies. Conclusion: The majority of the reported ICERs indicated that falls prevention programs were cost‐effective, but methodological differences between studies hampered direct comparison of the cost‐effectiveness of program types. The results imply that investing in falls prevention programs for adults aged 60 and older is cost‐effective. Home assessment programs (ICERs < $40,000/QALY) were the most cost‐effective type of program for community‐dwelling older adults, and medication adjustment programs (ICERs < $13,000/QALY) were the most cost‐effective type of program for older adults living in a residential care facility.

Results 1 - 10 of 61

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News

Moving Memory

Moving Memory Practice example about how the Moving Memory Dance Theatre Company is challenging perceived notions of age and ageing.

Chatty Cafe Scheme

Chatty Cafe Scheme Practice example about how the Chatty Cafe Scheme is helping to tackle loneliness by bringing people of all ages together

Oomph! Wellness

Oomph! Wellness Practice example about how Oomph! Wellness is supporting staff to get older adults active and combat growing levels of social isolation

KOMP

KOMP Practice example about how KOMP, designed by No Isolation is helping older people stay connected with their families

LAUGH research project

LAUGH research project Practice example about a research project to develop highly personalised, playful objects for people with advanced dementia
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