The effect of multidomain lifestyle intervention on health care service use and costs - secondary analyses from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): a randomised controlled trial

Abstract

Background: The Finnish multidomain lifestyle intervention study to prevent cognitive impairment and disability (FINGER, N = 1259), a randomised controlled trial had beneficial effects on morbidity in older people, but to what extent such a lifestyle intervention may affect the use of health care services and their costs especially in long term are unknown.

Objective: This study investigated the effect of a two-year FINGER multidomain intervention on health care service use during the 8-year follow-up. The costs of service use were also evaluated.

Methods: Health care service use obtained from national health care registers (days of inpatient hospital stay and long-term care, number of visits to emergency services, hospital as outpatient, home care, primary care physician and primary care nurse) was analysed among participants of the FINGER. Trial targeted community-dwelling people aged 60-77 years at risk for cognitive impairment, who were randomly allocated to the multidomain intervention or control group. Costs were evaluated as the mean costs of services used.

Results: There were no significant differences in total health care costs between the intervention and control groups. The participants in the intervention group, however, had a lower use of the hospital inpatient care (RR 0.73, 95% CI 0.54-1.00) and emergency services (RR 0.83, 95% CI 0.70-0.97) than those in the control group. Hospital inpatient care was lower especially among men. The use of other types of health care services did not differ between the groups. The costs of health care service use without including long-term care were lower in the intervention group (RR 0.81, 95% CI 0.68-0.99).

Conclusions: The FINGER intervention has a potential to reduce the need for the inpatient hospital care and emergency visits and associated costs, especially among men.

Keywords: cost; health care service use; multidomain lifestyle intervention; older people; register.