Modelling the Economic Impact of Reducing Loneliness in Community Dwelling Older People in England.

David McDaid,A-La Park

doi:10.3390/ijerph18041426

Abstract

Loneliness has been associated with poor mental health and wellbeing. In England, a 2018 national strategy on loneliness was published, and public health guidelines recommend participation in social activities. In the absence of existing economic evidence, we modelled the potential cost effectiveness of a service that connects lonely older people to social activities against no-intervention. A 5-year Markov model was constructed from a health and social care perspective. Parameters were drawn from the literature, with the intervention structure based on an existing loneliness alleviation programme implemented in several settings across England. Univariate and probabilistic sensitivity analyses were undertaken. The total expected cost per participant in the intervention group is £7131 compared to £6783 in the usual care group with 0.45 loneliness free years (LFY) gained. The incremental cost per LFY gained is £768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations. Potentially such interventions may be cost-effective but are unlikely to be cost-saving even allowing for sustained effects and cumulative adverse health and social care events averted. Empirical studies are needed to determine the cost-effectiveness of these interventions, ideally mapping changes in loneliness to the quality of life, in order to allow the key metric in health economic studies, cost per quality adjusted life year to be estimated.

Highlights

Loneliness can be thought of as a subjective, unpleasant, and distressing phenomenon resulting from a discrepancy between an individual’s desired and achieved levels of social relations [1]
The incremental cost per loneliness free years (LFY) gained is £768; in the probabilistic sensitivity analysis the intervention is cost saving in 3.5% of iterations
Loneliness has been recognised as a risk factor for poor mental health and wellbeing by the National Institute for Health and Care Excellence (NICE), an independent authority that makes recommendations on appropriate public health interventions in England

Summary

Introduction

Loneliness can be thought of as a subjective, unpleasant, and distressing phenomenon resulting from a discrepancy between an individual’s desired and achieved levels of social relations [1]. Even though periods of loneliness for all of us are an inevitable part of life, there is increasing evidence suggesting that enduring loneliness potentially can have an adverse impact on mental and physical health across different age groups [2,3,4,5]. Loneliness has been recognised as a risk factor for poor mental health and wellbeing by the National Institute for Health and Care Excellence (NICE), an independent authority that makes recommendations on appropriate public health interventions in England. Current NICE guidelines to promote the mental health and wellbeing of older people include support for actions to both publicise, and if there is not enough existing provision, consider providing a range of

Methods

Discussion

Conclusion