Modeled cost-effectiveness of the Experience Corps Baltimore based on a pilot randomized trial.
The Experience Corps program was designed to harness the social capital of an aging society to improve outcomes for public elementary schools. The objectives of this article are (1) to model the cost-effectiveness of the Experience Corps Baltimore using data from a pilot randomized trial, including costs, older adults' health status, and quality of life and cost data from the Medical Expenditure Panel Survey, and (2) to describe the relationship between children experiencing increased expected lifetime earnings through improved educational attainment resulting from exposure to the Experience Corps Baltimore volunteers and the program's costs and cost-effectiveness. On average, each quality adjusted life year (QALY) gained by older adults in Experience Corps Baltimore costs $205,000. The lower bound of the 95% confidence interval for the cost-effectiveness is $65,000/QALY. The upper bound is undefined as 15% of the simulations indicated no QALY improvements. If 0.3% of students exposed to the Experience Corps Baltimore changed from not graduating to graduating, the increased lifetime earnings would make the incremental cost-effectiveness ratio $49,000/QALY. If an additional 0.1% changed to graduating from high school, the program would be cost-saving. Using conservative modeling assumptions and excluding benefits to teachers, principals, and the surrounding community, the Experience Corps Baltimore appears expensive for the older adults' health improvements, but requires only small long-term benefits to the target children to make the program cost-effective or cost-saving.
Frick
Kevin D
KD
Health Services Research and Development Center, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205-1901, USA. kfrick@jhsph.edu
Carlson
Michelle C
MC
Glass
Thomas A
TA
McGill
Sylvia
S
Rebok
George W
GW
Simpson
Crystal
C
Fried
Linda P
LP
D000368:Aged / Q000523:psychology*; D015142:Baltimore; D002648:Child; D002669:Child Welfare / Q000191:economics*; D003362:Cost-Benefit Analysis; D004522:Educational Status; D005178:Faculty; D005260:Female; D006293:Health Promotion / Q000191:economics* / Q000379:methods; D006801:Humans; D008297:Male; D010865:Pilot Projects; D019057:Quality-Adjusted Life Years; D012574:Schools / Q000191:economics*; D012944:Social Support; D014838:Volunteers / Q000523:psychology*; D000078329:Workforce