Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice.
OBJECTIVE
The home environment is a key determinant of health, quality of life, and well-being. Given its relevance for such aspects, the scarcity of evaluations of housing adaptation (HA) interventions aimed at removing environmental barriers and accessibility problems in the homes of people with disabilities is surprising. This article aims to contribute to the development of strategies for economic evaluations of HA interventions, by stimulating the dissemination and application of the concepts of effectiveness, cost, and cost-effectiveness as used within health economics.


METHODS
The focus is limited to three overarching questions for the evaluation of HA interventions. Considering X and Y as two hypothetical interventions for the same individual case, the article asks: (i) Will X be more effective than Y?; (ii) Will X cost more than Y?, and (iii) Will X be more cost-effective than Y? Vignette-like descriptions of fictional cases are used to exemplify the economic concepts explained in the article.


CONCLUSIONS
In the conclusion, the need is stressed for new experimental data regarding both costs and outcomes of HA interventions, in order to realize sound evaluations with the potential to inform policy and professionals in this field. Given the heterogeneity among national contexts, systematic approaches applied in a coherent manner could strengthen cross-national research and collaborations.
Scientific Direction, Italian National Research Centre on Aging (INRCA) , Italy.
Carlos
C
Chiatti
Susanne
S
Iwarsson
D001107:Architectural Accessibility / Q000191:economics*; D003362:Cost-Benefit Analysis; D004185:Disability Evaluation; D006798:Housing / Q000191:economics*; D006801:Humans; D057187:Independent Living; D009788:Occupational Therapy / Q000379:methods*; D015397:Program Evaluation; D011788:Quality of Life; D012656:Self-Help Devices; D013548:Sweden
Cost-analysis; economic evaluation; outcome research