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 .
Cost-utility of a visiting service for older widowed individuals: Randomised trial
Background Despite a growing underst and ing of the effectiveness of bereavement interventions and the groups that benefit most from them , we know little about the cost-effectiveness of bereavement interventions . Methods We conducted a cost-utility analysis alongside a r and omized clinical trial on a visiting service for older widowed individuals ( n = 110 ) versus care as usual ( CAU ; n = 106 ) .  The visiting service is a selective bereavement intervention that offers social support to lonely widows and widowers by a trained volunteer . Participants were contacted 6–9 months post-loss . Eleven percent of all contacted persons responded and eight percent participated in the trial . The primary outcome measure was quality adjusted life years ( QALYs ) gained ( assessed with the EQ-5D ) , which is a generic measure of health status . Costs were calculated from a societal perspective excluding costs arising from productivity losses . Using the bootstrap method , we obtained the incremental cost utility ratio ( ICUR ) , projected these on a cost-utility plane and presented as an acceptability curve . Results Overall , the experimental group demonstrated slightly better results against slightly higher costs . Whether the visiting service is acceptable depends on the willingness to pay : at a willingness to pay equal to zero per QALY gained , the visiting service has a probability of 31 % of being acceptable ; beyond € 20,000 , the visiting service has a probability of 70 % of being more acceptable than CAU . ConclusionS elective bereavement interventions like the visiting service will not produce large benefits from the health economic point of view , when targeted towards the entire population of all widowed individuals . We recommend that in depth analyses are conducted to identify who benefits most from this kind of interventions , and in what subgroups the incremental cost-utility is best . In the future bereavement interventions are then best directed to these groups . Trial registration Controlled trials IS RCT
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 .