Can Aging in Place Be Cost Effective? A Systematic Review
Can Aging in Place Be Cost Effective? A Systematic Review
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DOI：
10.1371/journal.pone.0102705
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发表时间：
2014-07-24
期刊：
影响因子：
3.7
通讯作者：
Wildman, John
中科院分区：
文献类型：
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作者：
Graybill, Erin M.;McMeekin, Peter;Wildman, John
研究目的：系统地回顾专门帮助老年人“就地养老”的辅助生活技术 (ALT) 的成本、成本最小化和成本效益研究，并强调需要进一步研究来为有关就地养老的决策提供信息。设计：65 岁以上的人及其住家护理人员（如适用），使用 ALT 在家中养老，而不是社区居住安排。方法：使用预定义的搜索策略对两个关键的经济和成本评估数据库进行研究。 NHS EED，注意。研究使用坎贝尔和科克伦经济方法组推荐的方法进行评估，并以叙述综合风格呈现。结果：从分布在不同地理范围的北美地区确定了八项符合条件的研究。大多数研究报告称 ALT 干预组的资源使用成本低于对照组；尽管必须考虑方法学质量低以及各研究报告的个体成本和结果的异质性。 意义：研究表明，在某些情况下 ALT 可能会降低成本，尽管确定的数据很少且质量较差。没有使用捕捉生活质量提高的方法，因此可能会错过对健康和福祉的潜在影响。需要使用新的发展（例如能力方法）进行进一步的研究。在得出关于 ALT 的使用的可靠结论之前，需要进行高质量的研究来评估 ALT 就地老龄化的成本效益。
Purpose of the Study: To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place.Design: People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement.Methods: Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style.Results: Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered.Implications: The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.