功能能力下降的老年人多成分训练计划的成本效益：经济评估。

IF 4.3

Experimental gerontology Pub Date : 2025-09-25 DOI:10.1016/j.exger.2025.112911

J. Subías-Perié , D. Navarrete-Villanueva , A.I. Fernández-García , A. Moradell , J.T. Alcalá-Nalvaiz , E.J. Groessl , I. Ara , S. Vila-Maldonado , J. Pérez-Gómez , M. Gonzalez-Gross , A. Gómez-Cabello , G. Vicente-Rodríguez , J.A. Casajús

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引用次数: 0

摘要

目的：本研究旨在(I)检查实施多成分培训（MCT）计划所需的资源，（II）评估其对医疗保健利用成本的影响，以及（III）评估其在功能能力下降的老年人中的成本效益。方法：将123名老年人（平均年龄：80.3 ± 5.9 岁）分为对照组（n = 64）和训练组（n = 59）。TRAIN组进行了为期6个月的MCT计划，其中包括有氧运动，阻力训练，柔韧性和平衡成分，而CON组继续他们的常规护理。在三个不同的时间点分别使用短物理性能电池（SPPB）、Fried虚弱表型和EuroQol-5D （EQ-5D）评估功能能力、虚弱和健康相关生活质量（HRQoL）。主要结局指标包括提供MCT的成本、医疗保健利用、质量调整生命年（QALYs）和增量成本效益比（ICER）。从卫生系统角度进行了为期6个月的分析。结果：CON组未观察到显著变化，TRAIN组在SPPB（+3.38 ± 1.32）、HRQoL（+0.07 ± 0.12）和虚弱（-0.64 ± 1.06）（均p ）方面有所改善。结论：6个月的exnet - elder 3.0培训计划显示，每增加SPPB点的ICER为115欧元，每减少虚弱点的ICER为407欧元，每增加QALY点的ICER为6274欧元。干预是低成本的（每位参与者164欧元），并在功能能力、HRQoL和虚弱方面产生了有临床意义的改善。这些发现强调了将有组织的、以群体为基础的锻炼规划纳入公共卫生战略的重要性，以解决与人口老龄化有关的日益严重的社会经济和健康负担。试验注册：ClinicalTrial.gov标识符：NCT03831841注册日期：2019年6月2日（最后更新日期：2020年7月2日）。

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Cost-effectiveness of a multicomponent training programme for older adults with decreased functional capacity: An economic evaluation

Purpose

This study aimed to (I) examine the resources required to implement a multicomponent training (MCT) programme, (II) assess its impact on health care utilisation cost, and (III) evaluate its cost-effectiveness in older adults with decreased functional capacity.

Methods

A total of 123 older adults (mean age: 80.3 ± 5.9 years) were allocated into a control (CON, n = 64) or training group (TRAIN, n = 59). The TRAIN group performed a 6-month MCT programme, which included aerobic exercise, resistance training, flexibility and balance components, while the CON group continued with their usual care. Functional capacity, frailty and health-related quality of life (HRQoL) were assessed at three different timepoints using the Short Physical Performance Battery (SPPB), Frailty Phenotype of Fried and the EuroQol-5D (EQ-5D), respectively. Primary outcome measures included the costs of delivering the MCT, health care utilisation, quality-adjusted life-years (QALYs), and the incremental cost effectiveness ratio (ICER). Analyses were conducted from a health system perspective with a 6-month time horizon.

Results

While no significant changes were observed in the CON group, the TRAIN group showed improvements in SPPB (+3.38 ± 1.32), HRQoL (+0.07 ± 0.12), and frailty (−0.64 ± 1.06) (all p < 0.05). The average cost per TRAIN participant was €164. Health care utilisation cost was lower for TRAIN compared to CON (€3091 and €4135, respectively). The ICERs were €115/point increase in SPPB and €407/point reduction in frailty score. The cost per QALY gained by the TRAIN participant relative to the usual care cost was €6274. At a willingness-to-pay threshold of €49,000/QALY (Spanish Health System), the probability of the exercise intervention being cost-effective was 100 %.

Conclusions

The 6-month Exernet-Elder 3.0 training programme demonstrated an ICER of €115 per SPPB point gained, €407 per point of frailty reduction, and €6274 per QALY gained. The intervention was low-cost (€164 per participant) and produced clinically meaningful improvements in functional capacity, HRQoL, and frailty. These findings underscore the importance of integrating a structured, group-based exercise programmes into public health strategies to address the growing socioeconomic and health burden associated with ageing populations.