Abstract
This report outlines a rapid economic evaluation of a nursing service for homeless people, taking as an example a service in Wirral, a borough of c.320,000 people in the North West of England. This service cost £60,393 ($96,876) in the year from April 2012-March 2013. The main outcome we looked at was the estimated change in quality adjusted life years (QALYs) experienced by clients. From looking at the evidence for cost effectiveness of some individual elements of this service, it would be regarded as cost effective using a willingness to pay threshold of £20,000 - £30,000 per QALY (quality adjusted life year) gained which is the UK standard recommended by NICE (the National Institute for Health and Care Excellence), or a threshold of less than $50,000 per QALY gained. Looking at six elements of the service; hep B and flu vaccinations, screening for gonorrhoea, chlamydia and hep C, and referral to alcohol treatment, the overall cost per QALY compared to no intervention is estimated at £8,876 ($14,238). There are likely to be a lot more elements of the service that are cost effective in improving people's health and wellbeing, reducing unnecessary Accident & Emergency presentations, and reducing the spread of infectious diseases.
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