Can aging in place be cost effective? A systematic review

PLoS One. 2014 Jul 24;9(7):e102705. doi: 10.1371/journal.pone.0102705. eCollection 2014.

Abstract

Purpose of the study: To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place.

Design: People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement.

Methods: Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style.

Results: Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered.

Implications: The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Assisted Living Facilities
  • Caregivers / economics*
  • Cost-Benefit Analysis / statistics & numerical data*
  • Female
  • Humans
  • Independent Living / economics*
  • Independent Living / statistics & numerical data
  • Male
  • North America
  • Quality of Life

Grants and funding

This work was supported by the Technology Strategy Board, Assisted Living Innovation Platform 3 and 4 programmes [project code 2377-25137] as part of the study titled ‘SALT’ (Designing Scalable Assistive Technologies and Services for Independent Health Living and Sustainable Market Development in the Mixed Digital Economy). The financial sponsors played no role in the design, execution, analysis or interpretation of data or writing of this review. The views expressed in this manuscript are entirely those of the authors and do not necessarily those of the funders.