Effects of preventive home visits on health care costs for ambulatory frail elders: a randomized controlled trial

Background and aims Reducing health care costs through preventive geriatric care has become a high priority in Japan. We analyzed data from a randomized controlled trial to examine the effects of a preventive home visit program on health care costs among ambulatory frail elders. Methods Structured p...

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Bibliographic Details
Published in:Aging clinical and experimental research 2013-10, Vol.25 (5), p.575-581
Main Authors: Kono, Ayumi, Kanaya, Yukiko, Tsumura, Chieko, Rubenstein, Laurence Z.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Ambulatory Care - economics
Clinical trials
Female
Frail Elderly
Geriatrics/Gerontology
Health Care Costs
Hospitalization - economics
House Calls - economics
Humans
Japan
Male
Medicine
Medicine & Public Health
Original
Original Article
Outpatient care facilities
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Summary:Background and aims Reducing health care costs through preventive geriatric care has become a high priority in Japan. We analyzed data from a randomized controlled trial to examine the effects of a preventive home visit program on health care costs among ambulatory frail elders. Methods Structured preventive home visits by nurses or care managers were provided to the visit group every 6 months over 2 years. The enrolled participants ( N  = 323) were randomly assigned to either the visit group ( N  = 161) or the control group ( N  = 162). We analyzed the health care costs, including the costs for hospitalizations and outpatient clinic utilization for participants who had health care insurance from the local government ( N  = 307). The visit group included 154 individuals in the visit group and 153 people in the control group. Results Total health care costs over the study period were not significantly different between groups, but at most monthly time points costs and those for outpatient clinic utilization in the visit group were lower than those in the control group. Hospitalizations, which accounted for more than ¥500,000 JPY per month, were less likely to occur more often among participants in the visit group ( N  = 71) than in the control group ( N  = 113) (OR = 0.63; p  = 0.002). Conclusions These results suggest that a preventive home visit program may reduce monthly health care costs, primarily by reducing hospitalization costs.
ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-013-0128-4