Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.
BACKGROUND Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services . The results of trials have been inconsistent and their cost-effectiveness uncertain . Home visits for a high-risk population rather than the general population seems a promising approach . We therefore studied the effects of a home visiting program for older people with poor health . This article describes the effects on health care use and associated cost . METHODS We conducted a r and omized clinical trial among 330 community-dwelling citizens , aged 70 - 84 years , in the Netherl and s. Participants in the intervention group ( n = 160 ) received eight home visits by a trained home nurse over an 18-month period ; a multidimensional geriatric assessment of problems was included . The main outcomes are : admissions to hospital , nursing home , and home for older persons ; contacts with medical specialists , general practitioners , and paramedics ; and hours of home care help . The data on health care use were mostly obtained from computerized data bases of various medical administration offices ; the follow-up period was 24 months . RESULTS Inpatient and outpatient health care use was similar for both groups , with the exception of a higher distribution of aids and in-home modifications in favor of the intervention group . No differences were found between the intervention and control group in health care cost . CONCLUSION The home visiting program did not appear to have any effect on the health care use of older people with poor health and had a low chance of being cost-effective . We conclude that these visits are probably not beneficial for such persons within the health care setting in the Netherl and s or comparable setting s in other Western countries
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .