The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Mar 2008
Randomized Controlled TrialEffects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.
Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population rather than the general population seems a promising approach. We therefore studied the effects of a home visiting program for older people with poor health. This article describes the effects on health care use and associated cost. ⋯ The home visiting program did not appear to have any effect on the health care use of older people with poor health and had a low chance of being cost-effective. We conclude that these visits are probably not beneficial for such persons within the health care setting in the Netherlands or comparable settings in other Western countries.
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J. Gerontol. A Biol. Sci. Med. Sci. · Mar 2008
Review Meta AnalysisMultidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials.
Multidimensional preventive home visit programs aim at maintaining health and autonomy of older adults and preventing disability and subsequent nursing home admission, but results of randomized controlled trials (RCTs) have been inconsistent. Our objective was to systematically review RCTs examining the effect of home visit programs on mortality, nursing home admissions, and functional status decline. ⋯ Multidimensional preventive home visits have the potential to reduce disability burden among older adults when based on multidimensional assessment with clinical examination. Effects on nursing home admissions are heterogeneous and likely depend on multiple factors including population factors, program characteristics, and health care setting.