Social value of preventing elderly depression with collaborative stepped care and productive ageing

Abstract

Approximately 10% of older adults living in the community has clinically significant depression in Hong Kong. The associated societal costs (e.g., years of life lost, direct healthcare and long-term care costs, disease complications) are huge. Previous analysis of Medicare and Medicaid claims data has suggested an additional direct healthcare costs for late-life depression ranging from US$5,771 to up to US$17,607 per person per year depending on care setting.

Indicated prevention (targeting older persons with high risk factors) and selective prevention (targeting those with high risk factors and mild symptoms) can reduce suffering and societal costs. Funded by the Hong Kong Jockey Club Charities Trust, this study aims to test a best practice model for effective outreach, engagement, and prevention of late-life depression in 3,840 community-dwelling older adults. The 3-year project has three components: (1) collaborative stepped care between elderly and mental health services; (2) productive ageing for active outreach and engagement; and (3) community empowerment for mental health literacy.

The overall social value of the model will be assessed using social return on investment (SROI) method, a type of cost-benefit analysis, to provide evidence for further service rollout. Following standard SROI study method, focus groups and interviews will be conducted to identify areas of changes and map outcomes/financial proxies with stakeholders, and quantitative data will be collected for evidencing, establishing impact and calculating SROI. We report here the service model, preliminary findings from focus groups and interviews, and the forecast SROI of the model.