scholarly journals The cost effectiveness of aging in place: A literature review

2021 ◽  
Vol 11 (1) ◽  
pp. 40-54
Author(s):  
Nguyen Tan Loi ◽  
Nguyen Tien Dung ◽  
Ho Nhut Quang
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Assisted Living ◽  
Social Life ◽  
Long Term Care ◽  
Economic Valuation ◽  
Aging In Place ◽  
Term Care ◽  
The Cost

The objective of this paper is to discover the evidence supporting or refuting the cost-effectiveness of Assisted Living Technology (ALT) in aging in place of older adults through a comprehensive presentation of cost studies and economic analyses. The search was conducted on two main databases for health economic valuation: The NHS economic valuation database (NHS EED) and the health economic valuation database (HEED). The study was evaluated using the protocol required by Campbell and Cochrane Economic Methods. As an aging society evolves, the need for long-term care services increases. The prevalence of chronic diseases increases in the older population; seniors may have to abandon their bative social life and need long-term care in a nursing home. Aging is a global phenomenon. Asia is aging rapidly. By 2030, the number of Asians aged 65 and over will increase from the current 300 million to 565 million. By 2050, this number will increase to 900 million, about one-sixth of the number of people in Asia. Aging trends are regional, but demographic changes are diverse. Countries such as Japan, South Korea, Singapore, and China, whose populations are steadily aging, are in extreme situations. Research has shown that ALT can reduce costs in some cases, but with little precise data and low quality. Later developments, e.g., capacity methods, should be used for further research. Qualitative research is needed to assess the cost-effectiveness of ALT before making reliable conclusions about the application.

scholarly journals Cost-effectiveness of zoledronic acid compared with sequential denosumab/alendronate for older osteoporotic women in Japan

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Mori ◽  
Carolyn J. Crandall ◽  
Tomoko Fujii ◽  
David A. Ganz
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Zoledronic Acid ◽  
Cost Saving ◽  
Fragility Fracture ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Term Care ◽  
Lifetime Horizon ◽  
The Cost

Abstract Summary Among hypothetical cohorts of older osteoporotic women without prior fragility fracture in Japan, we evaluated the cost-effectiveness of two treatment strategies using a simulation model. Annual intravenous zoledronic acid for 3 years was cost-saving compared with biannual subcutaneous denosumab for 3 years followed by weekly oral alendronate for 3 years. Purpose Osteoporosis constitutes a major medical and health economic burden to society worldwide. Injectable treatments for osteoporosis require less frequent administration than oral treatments and therefore have higher persistence and adherence with treatment, which could explain better efficacy for fracture prevention. Although annual intravenous zoledronic acid and biannual subcutaneous denosumab are available, it remains unclear which treatment strategy represents a better value from a health economic perspective. Accordingly, we examined the cost-effectiveness of zoledronic acid for 3 years compared with sequential denosumab/alendronate (i.e., denosumab for 3 years followed by oral weekly alendronate for 3 years, making the total treatment duration 6 years) among hypothetical cohorts of community-dwelling osteoporotic women without prior fragility fracture in Japan at ages 65, 70, 75, or 80 years. Methods Using a previously validated and updated Markov microsimulation model, we obtained incremental cost-effectiveness ratios (Japanese yen [¥] (or US dollars [$]) per quality-adjusted life-year [QALY]) from the public healthcare and long-term care payer’s perspective over a lifetime horizon with a willingness-to-pay of ¥5 million (or $47,500) per QALY. Results In the base case, zoledronic acid was cost-saving (i.e., more effective and less expensive) compared with sequential denosumab/alendronate. In deterministic sensitivity analyses, results were sensitive to changes in the efficacy of zoledronic acid or the cumulative persistence rate with zoledronic acid or denosumab. In probabilistic sensitivity analyses, the probabilities of zoledronic acid being cost-effective were 98–100%. Conclusions Among older osteoporotic women without prior fragility fracture in Japan, zoledronic acid was cost-saving compared with sequential denosumab/alendronate.

A Comparison of Wandering Behavior in Nursing Homes and Assisted Living Facilities

2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Challenging Behavior ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Training Requirements ◽  
Care Facilities ◽  
Staffing And Training

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.

Aging in Place

2018 ◽  
pp. 259-276 ◽  
Author(s):  
Ben Yuk Fai Fong ◽  
Vincent T. Law
Keyword(s):  
Social Networks ◽  
Aging Process ◽  
Local Community ◽  
Long Term Care ◽  
Aging In Place ◽  
Social Psychological ◽  
Term Care ◽  
Residential Homes ◽  
The Social

Aging is a function of time and is a natural and integral part of the life cycle. Aging process differs among individuals and brings all kinds of changes, affecting not just the physical body and its functions, but also to the social, psychological and financial situations to individuals. Aging in place (AIP) is a common preference among older people for remaining in their local community and maintaining their social networks throughout the aging process. Issues about appropriateness of aging in place, long-term care, and residential homes are discussed. Some models and recommendations are discussed, completed with thoughts on future studies.

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