Associations of Participation in Community Assets with Health-Related Quality of Life and Health Care Utilisation: a cross-sectional study of older people in the community

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Abstract

Background: Community assets are promoted as a way to improve quality of life and reduce healthcare utilisation. However, the quantitative impact of participation in community assets on these outcomes is not known.
Methods: We examined the association between participation in community assets and health-related quality of life (EuroQol-5D-5L) and healthcare utilisation in 3686 individuals aged ≥65 years. We estimated the unadjusted differences in EuroQol-5D-5L scores and healthcare utilisation between participants and non-participants in community assets and then used multivariate regression to examine scores adjusted for socio-demographic and limiting long-term health conditions. We derived the net benefits of participation using a range of threshold values for a Quality-Adjusted Life Year.
Results: 50% of individuals reported participation in community assets. Their EuroQol-5D-5L scores were 0.094 (95% CI 0.077 to 0.111) points higher than non-participants. Controlling for socio-demographic characteristics reduced this differential to 0.081 (95% CI 0.064 to 0.098). Further controlling for limiting long-term conditions reduced this effect to 0.039 (95% CI 0.025 to 0.052). Once we adjusted for socio-demographic and limiting long-term conditions, the reductions in healthcare utilisation and costs associated with community asset participation were not statistically significant. Based on a threshold value of £20,000 per Quality-Adjusted Life Year, the net-benefits of participation in community assets were £763 (95% CI £478 to £1048) per participant per year.
Conclusion: Participation in community assets is associated with substantially higher health-related quality of life but is not associated with lower healthcare costs. The social value of developing community assets is potentially substantial.

Bibliographical metadata

Original languageEnglish
JournalBMJ Open
DOIs
Publication statusPublished - 10 Feb 2017

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