Activities of Daily Living, Cost Effectiveness, Housing
Conditions
Keywords
Housing adaptation, Independence, Costs
Brief summary
The rationale underlying this project is the fact that HA is a very common compensatory interven¬tion within municipality health care, undertaken to support an independent living in the own home. In addition, MD are frequently prescribed and used among HA clients in order to compensate for declined body functions. In spite of this, knowledge of their effects for the individual and the society is still scarce. In particular, systematic, evidence-based strategies based on clear-cut conceptual definitions and descriptions of procedures are lacking. Such strategies are crucial in order to evaluate the effects of HA and MD. In addition, longterm cost-effectiveness evaluations are crucial for policy implementation. The overarching aim is to investigate outcomes of HA on aspects of home and health for sub-groups of persons with disabilities. The specific aims are to: * Investigate the effects of HA on home and health related outcomes, i.e. usability, fear of falling, activity/participation and health-related quality of life for different subgroups of persons, e.g. MD users and non MD-users * Investigate the use of a new practice strategy for HA on home and health related outcomes for subgroups of persons with disabilities in terms of differences between municipalities * Investigate societal level outcomes of HA and MD, i.e. costs and quality adjusted life years * Gain a deeper understanding of the processes behind changes in outcomes We hypothesise that using a structure strategy for housing adaptation and mobility devices case management in ordinary practice in Swedish municipalities increase activity, participation, the usability of the home, and reduces societal costs.
Detailed description
The ultimate goal of the project is to improve the housing situation of older people and people with disabilities, by determining the long term effects of housing adaptations (HA) for clients and society, and transferring this knowledge into guidelines for practitioners in the housing and building planning sector. Specific research questions are: RQ1. What are the long-term effects of HA for clients (individual goals achievement, activity, participation, health-related quality of life, usability, falls, functional capacity and use of mobility devices (MD), mortality, health care and social services consumption, and relocation)? RQ2. What are the long-term effects of HA for society (costs and cost- effectiveness)? RQ3. What are the barriers and facilitators to knowledge transfer in the area of HA? RQ4. How can evidence based knowledge be transferred into practical guidelines for housing and building planning in Sweden?
Interventions
BEHAVIORALNew Practice Strategy
Application of a structured case management strategy on housing adaptation cases
Sponsors
Lund University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Persons receiving housing adaptation * Above 20 years
Exclusion criteria
* Persons with language deficits and/or cognitive decline
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ADL Staircase | Differences in changes between intervention and control sites at baseline and 3, 6,12, 24 and 36 months after | The ADL Staircase measures dependence on other persons in daily activities. Combined interview and observation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Falls Efficacy Scale- FES-I | Differences in changes between intervention and control sites at baseline and 3, 6, 12, 24 and 36 months after | FES-I measures perceived fear of falling |
Other
| Measure | Time frame | Description |
|---|---|---|
| Usability of the home, UIMH | Differences in changes between intervention and control sites between baseline and 3, 6,12,24 and 36 months after | Self-rated assessment measuring the extent to which the person can perform Daily activities in the housing |
| Costs of housing adaptations | 3,6, 12, 24 and 36 months after, for the whole sample | The actual costs for the housing adaptation, including costs for travel, work hours, and material will be calculated based on invoices benefit |
| Cost-benefit for client and society | At 24 and 36 months after the housing adaptation, for the whole sample | The cost-benefit of the housing adaptation will be calculated based on health economic models utilising data from EQ-5D instrument |
Countries
Sweden
Outcome results
None listed