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Research article
Economic Evaluation of Quality Improvement Interventions Targeting Elderly Population in Long-term Care: A Scoping Review
Asif Raza Khowaja
Department of Health Sciences at Brock University, St. Catharines Ontario, Canada
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2106-9918
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Quality improvement (QI) has received much wider attention in public policy, given the ever-increasing aging population and growing demand of long-term care (LTC). In the policy context, health system planners and administrators need to know the evidence on cost-effectiveness for resource allocation decisions. The objectives of this study were to: identify costs and benefits of the QI strategies in the economic literature; and synthesize the methodological approaches used in the economic studies and reported evidence around the cost-effectiveness of QI strategies in LTC.
Methods: A scoping review of three online databases, including PubMed, EconLit, and Google Scholar, was conducted to identify economic studies focusing on elderly population published from September 2010 to August 2020. A combination of search expressions was used to identify the original research articles. Study titles and abstracts were screened, and only full-text articles meeting the inclusion criteria were retained in the review. A standard data extraction template was used capturing patient population, intervention, comparator, the outcome of interest, and study design (PICOS).
Results: The search identified 657 records, of which 16 were included in the review. The financial costs were categorized into three groups: (i) developmental, (ii) operational, and (iii) health resource utilization. The terms ‘Quality of life,’ ‘Health-related Quality of Life’, and ‘Quality of Care’ were interchangeably used to express the health outcomes. This study showed mixed results suggesting a substantial variability around cost-effectiveness of QI interventions targeting elderly population in LTC. Almost all studies reported a public payer perspective and a discount rate ranged from 0 to 7%. A poorly defined baseline, the complex nature of the intervention, a lack of appropriate comparator, and varying duration of implementation were key methodological limitations.
Conclusions: This review highlights important knowledge gaps regarding societal costs and inconsistencies in reporting of the outcome measures. More research is needed to analyze long-term costs and consequences to better inform decisions on resource allocation in LTC.
Keywords
economic evaluation, costs, benefits, quality improvement and long-term care
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This is a preprint. It has not completed peer review.
Research article
Economic Evaluation of Quality Improvement Interventions Targeting Elderly Population in Long-term Care: A Scoping Review
Asif Raza Khowaja
Department of Health Sciences at Brock University, St. Catharines Ontario, Canada
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2106-9918
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 22 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Quality improvement (QI) has received much wider attention in public policy, given the ever-increasing aging population and growing demand of long-term care (LTC). In the policy context, health system planners and administrators need to know the evidence on cost-effectiveness for resource allocation decisions. The objectives of this study were to: identify costs and benefits of the QI strategies in the economic literature; and synthesize the methodological approaches used in the economic studies and reported evidence around the cost-effectiveness of QI strategies in LTC.
Methods: A scoping review of three online databases, including PubMed, EconLit, and Google Scholar, was conducted to identify economic studies focusing on elderly population published from September 2010 to August 2020. A combination of search expressions was used to identify the original research articles. Study titles and abstracts were screened, and only full-text articles meeting the inclusion criteria were retained in the review. A standard data extraction template was used capturing patient population, intervention, comparator, the outcome of interest, and study design (PICOS).
Results: The search identified 657 records, of which 16 were included in the review. The financial costs were categorized into three groups: (i) developmental, (ii) operational, and (iii) health resource utilization. The terms ‘Quality of life,’ ‘Health-related Quality of Life’, and ‘Quality of Care’ were interchangeably used to express the health outcomes. This study showed mixed results suggesting a substantial variability around cost-effectiveness of QI interventions targeting elderly population in LTC. Almost all studies reported a public payer perspective and a discount rate ranged from 0 to 7%. A poorly defined baseline, the complex nature of the intervention, a lack of appropriate comparator, and varying duration of implementation were key methodological limitations.
Conclusions: This review highlights important knowledge gaps regarding societal costs and inconsistencies in reporting of the outcome measures. More research is needed to analyze long-term costs and consequences to better inform decisions on resource allocation in LTC.
Figure 1