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Updated: May 14, 2025

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
How to Assess Health Gains
Giovanni Guarducci1,2, Gabriele Messina1,3, Chiara Siragusa3
1Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy.
Abstract:
Background/Objectives: As life expectancy rises and the epidemiological landscape of chronic diseases evolves, the necessity to assess and improve the overall health status of the population becomes increasingly fundamental. Therefore, evaluating health gains is a crucial challenge for modern health systems, particularly in the context of limited resources and increasing demand for services. The aim of this study is to assess health gains and their costs, with data provided by a private Italian clinic. Methods: We conducted a retrospective study on 129 patients admitted between June 2020 and August 2023 in a solvent ward for short-term planned hospitalization. The patients completed the EQ-5D-5L questionnaire at both admission and discharge. Quality-Adjusted Life Years (QALYs) were estimated based on the difference in EQ-5D-5L scores between discharge and admission, assuming that health gains persist up to two years post-discharge. Through QALYs value and hospitalization cost, a cost-utility analysis was performed. Descriptive and statistical analyses were carried out using STATA SE/14.0 software. Results: Of the studied sample, 55% was female, the median age was 81 [11] years old, and the median length of stay (LoS) was 16 [16] days. The patients gained, in median, 0.33 [0.38] in QALY, which was higher for males (0.35 [0.34]) than females (0.29 [0.45]). The QALY gained was greater for the non-geriatric patients (0.41 [0.42]) than geriatric ones (0.32 [0.38]) (p > 0.05). Those with a longer LoS showed a higher gain in QALY (0.35 [0.42]) than those with a shorter one (0.23 [0.29]) (p < 0.05). The cost per QALY gained was, in median, EUR 14,337, which was lower in males (EUR 13,803), in non-geriatric patients (EUR 13,743), and in patients with a shorter LoS (EUR 10,670) (p > 0.05). Conclusions: Although QALY gains differed among the groups, the median cost per QALY remained consistent. These results highlight the need for targeted interventions to optimize resource allocation, both by integrating data into allocation strategies and by employing a multidisciplinary approach to tailor interventions.
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