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- Title
Cost-Effectiveness of Preventive Occupational Therapy for Independent-Living Older Adults.
- Authors
Hay, Joel; LaBree, Laurie; Luo, Roger; Clark, Florence; Carlson, Mike; Mandel, Deborah; Zemke, Ruth; Jackson, Jeanne; Azen, Stanley P.
- Abstract
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.
- Subjects
OCCUPATIONAL therapy; HEALTH of older people
- Publication
Journal of the American Geriatrics Society, 2002, Vol 50, Issue 8, p1381
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1046/j.1532-5415.2002.50359.x