Cost-effectiveness of preventive occupational therapy for independent-living older adults

J Am Geriatr Soc. 2002 Aug;50(8):1381-8. doi: 10.1046/j.1532-5415.2002.50359.x.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cost-Benefit Analysis
  • Female
  • Health Care Costs
  • Health Services for the Aged / economics*
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy / economics*
  • Preventive Health Services / economics*
  • Program Evaluation
  • Quality of Life
  • Quality-Adjusted Life Years