Cost-effectiveness of interventions to support self-care: a systematic review.
OBJECTIVE
Interventions to support patient self-care of their condition aim to improve patient health and reduce health service costs. Consequently, they have attracted considerable policy interest. There is some evidence of clinical effectiveness but less attention has been paid to whether these interventions are cost-effective. This study examines the quality and quantity of existing evidence of the cost-effectiveness.


METHODS
A systematic review was carried out to assess the extent and quality of economic evaluations of self-care support interventions. Thirty-nine economic evaluations were assessed against a quality checklist developed to reflect the special features of these interventions.


RESULTS
The majority of the studies claimed that self-care support interventions were cost-effective or cost saving. The overall quality of economic evaluations was poor because of flaws in study designs, especially a narrow definition of relevant costs and short follow-up periods.


CONCLUSIONS
The current evidence base does not support any general conclusion that self-care support interventions are cost-effective, but ongoing trials may provide clearer evidence.
Richardson
Gerry
G
Centre for Health Economics, University of York, Heslington, York YO10 5DD, UK. gar2@york.ac.uk
Gravelle
Hugh
H
Weatherly
Helen
H
Ritchie
Gill
G
D003362:Cost-Benefit Analysis; D006801:Humans; D012648:Self Care / Q000191:economics*; D012944:Social Support; D013222:State Medicine; D006113:United Kingdom