Cost-utility analysis of a preventive home visit program for older adults in Germany

Abstract BackgroundHearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community based mobile hearing clinic (MHC).MethodsParticipants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years.ResultsThere were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8,996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased.ConclusionsHA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.

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Cost-utility analysis of hearing aid device for older adults in the community: a delayed start study

BMC Health Services Research ◽

10.1186/s12913-020-05977-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Palvinder Kaur ◽

Sheue Lih Chong ◽

Palvannan Kannapiran ◽

W.-S. Kelvin Teo ◽

Charis Ng Wei Ling ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cost Effectiveness ◽

Healthcare Costs ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis ◽

Index Visit ◽

Life Years ◽

The Cost

Abstract Background Hearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community-based mobile hearing clinic (MHC). Methods Participants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥ 18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years. Results There were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased. Conclusions HA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.

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Cost-Utility Analysis of Preventive Home Visits in Older Adults

Value in Health ◽

10.1016/j.jval.2014.08.1569 ◽

2014 ◽

Vol 17 (7) ◽

pp. A511 ◽

Cited By ~ 1

Author(s):

C. Brettschneider ◽

T. Luck ◽

S. Fleischer ◽

G. Roling ◽

K. Beutner ◽

...

Keyword(s):

Older Adults ◽

Home Visits ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis ◽

Preventive Home Visits

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Cost-Utility Analysis of Long-Acting Beta Agonists versus Leukotriene Receptor Antagonists in Older Adults with Persistent Asthma Receiving Concomitant Inhaled Corticosteroid Therapy

Value in Health ◽

10.1016/j.jval.2016.02.004 ◽

2016 ◽

Vol 19 (5) ◽

pp. 537-543 ◽

Cited By ~ 3

Author(s):

Shoroq M. Altawalbeh ◽

Joshua M. Thorpe ◽

Carolyn T. Thorpe ◽

Kenneth J. Smith

Keyword(s):

Older Adults ◽

Corticosteroid Therapy ◽

Persistent Asthma ◽

Cost Utility ◽

Cost Utility Analysis ◽

Inhaled Corticosteroid ◽

Utility Analysis ◽

Beta Agonists ◽

Leukotriene Receptor ◽

Long Acting

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Cost-Utility Analysis of Hearing Aid Device for Older Adults in the Community: A Delayed Start Study

10.21203/rs.3.rs-64897/v1 ◽

2020 ◽

Author(s):

Palvinder Kaur ◽

Sheue Lih Chong ◽

Palvannan Kannapiran ◽

Kelvin WS Teo ◽

Charis Ng Wei Ling ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Cost Effectiveness ◽

Healthcare Costs ◽

Cost Utility ◽

Cost Utility Analysis ◽

Utility Analysis ◽

Index Visit ◽

Life Years ◽

The Cost

Abstract Background Hearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community based mobile hearing clinic (MHC).Methods Participants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years.Results There were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8,996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased.Conclusions HA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.

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