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Assessing the value for money of an integrated health and wellbeing service in the UK

Author

Listed:
  • Visram, Shelina
  • Walton, Nick
  • Akhter, Nasima
  • Lewis, Sue
  • Lister, Graham

Abstract

Lay health workers have been utilized to deliver health promotion programmes in a variety of settings. However, few studies have sought to determine whether these programmes represent value for money, particularly in a UK context. The present study involved an economic evaluation of Wellbeing for Life, an integrated health and wellbeing service in northern England. The service combined one-to-one interventions delivered by lay health workers (known as health trainers), group wellbeing interventions, volunteering opportunities and other community development activities. Value for money was assessed using an established economic model developed with input from a panel of commissioners and providers, and the main data source was the national health trainer data collection and reporting system. Between June 2015 and January 2017, behaviour change outcomes (i.e. whether client goals in relation to diet, physical activity, smoking or other behaviours, had been achieved) were recorded for 2433 of the 3179 individuals who accessed one-to-one interventions. The level of achievement observed gave an estimated total health gain of 287.7 quality-adjusted life years (QALYs). In addition, there were 4669 health-promoting events, five asset mapping projects and 1595 occurrences of signposting to other services. Combining the value of individual behaviour change with the value of these additional activities gave an overall net cost per QALY gained of £3900 and a total estimated societal value of at least £3.45 for every £1 spent on the service. These results suggest that the Wellbeing for Life service offered good value for money. Further research is needed to systematically and comprehensively determine the societal value of similar holistic, asset-based and lay-led approaches.

Suggested Citation

  • Visram, Shelina & Walton, Nick & Akhter, Nasima & Lewis, Sue & Lister, Graham, 2020. "Assessing the value for money of an integrated health and wellbeing service in the UK," Social Science & Medicine, Elsevier, vol. 245(C).
  • Handle: RePEc:eee:socmed:v:245:y:2020:i:c:s0277953619306562
    DOI: 10.1016/j.socscimed.2019.112661
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    References listed on IDEAS

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    1. Shelina Visram & Charlotte Clarke & Martin White, 2014. "Making and Maintaining Lifestyle Changes with the Support of a Lay Health Advisor: Longitudinal Qualitative Study of Health Trainer Services in Northern England," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-12, May.
    2. Helen Mason & Michael Jones‐Lee & Cam Donaldson, 2009. "Modelling the monetary value of a QALY: a new approach based on UK data," Health Economics, John Wiley & Sons, Ltd., vol. 18(8), pages 933-950, August.
    3. Witmer, A. & Seifer, S.D. & Finocchio, L. & Leslie, J. & O'Neil, E.H., 1995. "Community health workers: integral members of the health care work force," American Journal of Public Health, American Public Health Association, vol. 85(8), pages 1055-1058.
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