Associations of participation in community assets with health-related quality of life and healthcare usage: a cross-sectional study of older people in the community.
Community assets are promoted as a way to improve quality of life and reduce healthcare usage. However, the quantitative impact of participation in community assets on these outcomes is not known.



We examined the association between participation in community assets and health-related quality of life (HRQoL) (EuroQol-5D-5L) and healthcare usage in 3686 individuals aged ≥65 years. We estimated the unadjusted differences in EuroQol-5D-5L scores and healthcare usage between participants and non-participants in community assets and then used multivariate regression to examine scores adjusted for sociodemographic 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 (QALY).



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 sociodemographic 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 sociodemographic and limiting long-term conditions, the reductions in healthcare usage and costs associated with community asset participation were not statistically significant. Based on a threshold value of £20 000 per QALY, the net benefits of participation in community assets were £763 (95% CI £478 to £1048) per participant per year.



Participation in community assets is associated with substantially higher HRQoL but is not associated with lower healthcare costs. The social value of developing community assets is potentially substantial.
Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
Luke A
LA
Munford
NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.|Salford Royal NHS Foundation Trust, Salford, UK.
Mark
M
Sidaway
NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Amy
A
Blakemore
Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
Matt
M
Sutton
NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Pete
P
Bower
D000368:Aged; D000369:Aged, 80 and over; D003256:Community Participation / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000379:methods; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012042:Registries; D011795:Surveys and Questionnaires
HEALTH ECONOMICS; PUBLIC HEALTH