Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice

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TY - JOUR

T1 - Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice

AU - Chiatti, Carlos

AU - Iwarsson, Susanne

PY - 2014

Y1 - 2014

N2 - Objective: The home environment is a key determinant of health, quality of life, and well-being. Given its relevance for such aspects, the scarcity of evaluations of housing adaptation (HA) interventions aimed at removing environmental barriers and accessibility problems in the homes of people with disabilities is surprising. This article aims to contribute to the development of strategies for economic evaluations of HA interventions, by stimulating the dissemination and application of the concepts of effectiveness, cost, and cost-effectiveness as used within health economics. Methods: The focus is limited to three overarching questions for the evaluation of HA interventions. Considering X and Y as two hypothetical interventions for the same individual case, the article asks: (i) Will X be more effective than Y?; (ii) Will X cost more than Y?, and (iii) Will X be more cost-effective than Y? Vignette-like descriptions of fictional cases are used to exemplify the economic concepts explained in the article. Results and conclusion: In the conclusion, the need is stressed for new experimental data regarding both costs and outcomes of HA interventions, in order to realize sound evaluations with the potential to inform policy and professionals in this field. Given the heterogeneity among national contexts, systematic approaches applied in a coherent manner could strengthen cross-national research and collaborations.

AB - Objective: The home environment is a key determinant of health, quality of life, and well-being. Given its relevance for such aspects, the scarcity of evaluations of housing adaptation (HA) interventions aimed at removing environmental barriers and accessibility problems in the homes of people with disabilities is surprising. This article aims to contribute to the development of strategies for economic evaluations of HA interventions, by stimulating the dissemination and application of the concepts of effectiveness, cost, and cost-effectiveness as used within health economics. Methods: The focus is limited to three overarching questions for the evaluation of HA interventions. Considering X and Y as two hypothetical interventions for the same individual case, the article asks: (i) Will X be more effective than Y?; (ii) Will X cost more than Y?, and (iii) Will X be more cost-effective than Y? Vignette-like descriptions of fictional cases are used to exemplify the economic concepts explained in the article. Results and conclusion: In the conclusion, the need is stressed for new experimental data regarding both costs and outcomes of HA interventions, in order to realize sound evaluations with the potential to inform policy and professionals in this field. Given the heterogeneity among national contexts, systematic approaches applied in a coherent manner could strengthen cross-national research and collaborations.

KW - outcome research

KW - economic evaluation

KW - Cost-analysis

U2 - 10.3109/11038128.2014.900109

DO - 10.3109/11038128.2014.900109

M3 - Article

VL - 21

SP - 323

EP - 333

JO - Scandinavian Journal of Occupational Therapy

T2 - Scandinavian Journal of Occupational Therapy

JF - Scandinavian Journal of Occupational Therapy

SN - 1651-2014

IS - 5

ER -