Heat waves may cause increased mortality, especially among frail elderly. The consequences of heat waves can be prevented by reducing indoor temperature, increasing intake of water with relevant electrolytes and ongoing assessment of medication and chronic disease. The regional and municipal administrative bodies should create management plans for heat waves and other extreme weather situations.
We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person is able independently to transfer, walk indoors, go outdoors, walk outdoors in both pleasant and poor weather, and climb stairs. In 17 of 34 municipalities health visitors and general practitioners were offered geriatric training, which focused on early signs of disability, physical activity, and interdisciplinary follow-up. The remaining 17 municipalities offered preventive home visits as usual. Outcomes were measured in 4,034 persons aged 75 or 80 years old and dwelling at home. The difference in mean total costs between the intervention and the control group discounted at 3% was -856 euro (95% CI -2,455 to 744) in 75-year-olds and 694 euro (-2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (-0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration.
AIMS: In controlled intervention studies, a selective non-response or refusal to participate at baseline may bias measurable effects of the intervention. The aim of this study was to compare mortality and nursing home admission among older persons who accepted (participants) and older person who declined (non-participants) to join a controlled feasibility trial, and to describe and evaluate defined subgroups of non-participants. METHODS: Prospective controlled three-year intervention study (1999-2001) in 34 Danish municipalities with five-year follow-up. Randomization and intervention (education of municipality employees) was done at municipality level. In total 5,788 home-dwelling 75- and 80-year-olds living in these municipalities were invited to participate in the study. Written consent was obtained from 4,060 persons (participation rate 71%). RESULTS: During five-year follow-up non-participants had a higher mortality rate (survival analysis risk ratio RR = 1.5, 95% CI = 1.3-1.7, p