Abstract
BackgroundLoneliness and social isolation are recognised as social problems and denote a significant health burden. The aim of this study was to conduct a systematic literature review to explore the health state utility values (HSUVs) associated with loneliness and/or social isolation.MethodPeer-reviewed journals published in English language that reported both HSUVs along with loneliness and/or social isolation scores were identified through five databases. No restrictions were made relating to the population, study design or utility estimation method used.ResultsIn total, 19 papers were included; 12 included a measure of loneliness, four studies included a measure of social isolation and three studies considered both loneliness and social isolation. All studies focused on individuals with pre-existing health conditions—where the EQ-5D-3L instrument was most frequently used to assess HSUVs. HSUVs ranged from 0.5 to 0.95 in those who reported not being lonely, 0.42 to 0.97 in those who experienced some level of loneliness, 0.3 to 0.87 in those who were socially isolated and 0.63 to 0.94 in those who were not socially isolated.ConclusionThere was significant variation in HSUVs complicated by the presence of co-morbidities, population heterogeneity, variations in methods used to derive utility scores and differences in the measurement of loneliness and/or social isolation. Nevertheless, the lower HSUVs observed should be considered to significantly impact quality of life, though we also note the need for further research to explore the unique impact of loneliness and social isolation on HSUVs that can be used in the future economic evaluations.
Highlights
Loneliness and social isolation are recognised as social problems and denote a significant health burden
We aimed to systematically review the literature to assess the availability of health state utility values (HSUVs) associated with loneliness and/or social isolation across all age groups, with the intention that the findings can inform future model-based economic evaluations as well as provide an indication of the burden potentially associated with loneliness and social isolation
All populations and age groups Loneliness and/or social isolation Quantitative studies, reported the scores of utility weights relating to loneliness or social isolation Both direct elicitation methods and indirect utility valuation methods All countries Published in peer-reviewed journals
Summary
Loneliness and social isolation are recognised as social problems and denote a significant health burden. The aim of this study was to conduct a systematic literature review to explore the health state utility values (HSUVs) associated with loneliness and/or social isolation. Conclusion There was significant variation in HSUVs complicated by the presence of co-morbidities, population heterogeneity, variations in methods used to derive utility scores and differences in the measurement of loneliness and/or social isolation. While every individual will experience loneliness at some point in their life, some age groups are more prone to loneliness, for example, late adolescence or older people [6] Critical transitions during these life stages, from adolescence to adulthood, as well as decreasing economic and social resources, limitations in mobility and loss of spouse and relatives that are common in later life, are thought to explain why these age groups experience more loneliness and social isolation [6, 7]. It has been found that older adults who experience “extreme loneliness” have a greater chance of premature death [16]
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