Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention

Background: Recent reviews have shown that home visiting programmes that address parenting have the potential to improve long term health and social outcomes for children. However there are few studies exploring the cost-effectiveness of such interventions. The objective of this study was to evaluat...

Descripción completa

Detalles Bibliográficos
Autores principales: McIntosh, E, Barlow, J, Davis, H, Stewart-Brown, S
Otros Autores: Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom
Formato: Journal article
Lenguaje:English
Publicado: Oxford University Press 2009
Materias:
_version_ 1826306031472345088
author McIntosh, E
Barlow, J
Davis, H
Stewart-Brown, S
author2 Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom
author_facet Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom
McIntosh, E
Barlow, J
Davis, H
Stewart-Brown, S
author_sort McIntosh, E
collection OXFORD
description Background: Recent reviews have shown that home visiting programmes that address parenting have the potential to improve long term health and social outcomes for children. However there are few studies exploring the cost-effectiveness of such interventions. The objective of this study was to evaluate the cost-effectiveness of an intensive home visiting programme directed at vulnerable families during the antenatal and postnatal periods. Methods: The design was an economic evaluation alongside a multicentre randomized controlled trial, in which 131 eligible women were randomly allocated to receive 18 months of intensive home visiting (n=67) or standard services (n=64). Due to the public health nature of the intervention a cost-effectiveness analysis was undertaken from a societal perspective. Results: The mean 'societal costs' in the control and intervention arms were £3874 and £7120, respectively, a difference of £3246 (p<0.000). The mean 'health service only' costs were £3324 and £5685 respectively, a difference of £2361 (p<0.000). As well as significant improvements in maternal sensitivity and infant cooperativeness there was also a non-significant increase in the likelihood of the intervention group infants being removed from the home due to abuse and neglect. These incremental benefits were delivered at an incremental societal cost of £3246 per woman. Conclusions: The results of the study provide evidence to suggest that, within the context of regular home visits, specially trained home visitors can increase maternal sensitivity and infant cooperativeness and are better able to identify infants in need of removal from the home for child protection. The extent to which these benefits are 'worth' the societal cost of £3246 per woman however is a matter of judgement.
first_indexed 2024-03-07T06:41:46Z
format Journal article
id oxford-uuid:f9861f8b-e5fe-4f05-8be3-6729372f065c
institution University of Oxford
language English
last_indexed 2024-03-07T06:41:46Z
publishDate 2009
publisher Oxford University Press
record_format dspace
spelling oxford-uuid:f9861f8b-e5fe-4f05-8be3-6729372f065c2022-03-27T12:58:34ZEconomic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health interventionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f9861f8b-e5fe-4f05-8be3-6729372f065cEconomicsHealth and health policyPublic HealthEnglishOxford University Research Archive - ValetOxford University Press2009McIntosh, EBarlow, JDavis, HStewart-Brown, SFaculty of Public Health of the Royal Colleges of Physicians of the United KingdomBackground: Recent reviews have shown that home visiting programmes that address parenting have the potential to improve long term health and social outcomes for children. However there are few studies exploring the cost-effectiveness of such interventions. The objective of this study was to evaluate the cost-effectiveness of an intensive home visiting programme directed at vulnerable families during the antenatal and postnatal periods. Methods: The design was an economic evaluation alongside a multicentre randomized controlled trial, in which 131 eligible women were randomly allocated to receive 18 months of intensive home visiting (n=67) or standard services (n=64). Due to the public health nature of the intervention a cost-effectiveness analysis was undertaken from a societal perspective. Results: The mean 'societal costs' in the control and intervention arms were £3874 and £7120, respectively, a difference of £3246 (p<0.000). The mean 'health service only' costs were £3324 and £5685 respectively, a difference of £2361 (p<0.000). As well as significant improvements in maternal sensitivity and infant cooperativeness there was also a non-significant increase in the likelihood of the intervention group infants being removed from the home due to abuse and neglect. These incremental benefits were delivered at an incremental societal cost of £3246 per woman. Conclusions: The results of the study provide evidence to suggest that, within the context of regular home visits, specially trained home visitors can increase maternal sensitivity and infant cooperativeness and are better able to identify infants in need of removal from the home for child protection. The extent to which these benefits are 'worth' the societal cost of £3246 per woman however is a matter of judgement.
spellingShingle Economics
Health and health policy
Public Health
McIntosh, E
Barlow, J
Davis, H
Stewart-Brown, S
Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title_full Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title_fullStr Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title_full_unstemmed Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title_short Economic evaluation of an intensive home visiting programme for vulnerable families: a cost-effectiveness analysis of a public health intervention
title_sort economic evaluation of an intensive home visiting programme for vulnerable families a cost effectiveness analysis of a public health intervention
topic Economics
Health and health policy
Public Health
work_keys_str_mv AT mcintoshe economicevaluationofanintensivehomevisitingprogrammeforvulnerablefamiliesacosteffectivenessanalysisofapublichealthintervention
AT barlowj economicevaluationofanintensivehomevisitingprogrammeforvulnerablefamiliesacosteffectivenessanalysisofapublichealthintervention
AT davish economicevaluationofanintensivehomevisitingprogrammeforvulnerablefamiliesacosteffectivenessanalysisofapublichealthintervention
AT stewartbrowns economicevaluationofanintensivehomevisitingprogrammeforvulnerablefamiliesacosteffectivenessanalysisofapublichealthintervention