Background The Finnish multidomain lifestyle intervention study to prevent cognitive impairment and disability (FINGER, N = 1259), a randomised controlled trial had beneficial effects on morbidity in older people, but to what extent such a lifestyle intervention may affect the use of health care services and their costs especially in long term are unknown. Objective This study investigated the effect of a two-year FINGER multidomain intervention on health care service use during the 8-year follow-up. The costs of service use were also evaluated. Methods Health care service use obtained from national health care registers (days of inpatient hospital stay and long-term care, number of visits to emergency services, hospital as outpatient, home care, primary care physician and primary care nurse) was analysed among participants of the FINGER. Trial targeted community-dwelling people aged 60–77 years at risk for cognitive impairment, who were randomly allocated to the multidomain intervention or control group. Costs were evaluated as the mean costs of services used. Results There were no significant differences in total health care costs between the intervention and control groups. The participants in the intervention group, however, had a lower use of the hospital inpatient care (RR 0.73, 95% CI 0.54–1.00) and emergency services (RR 0.83, 95% CI 0.70–0.97) than those in the control group. Hospital inpatient care was lower especially among men. The use of other types of health care services did not differ between the groups. The costs of health care service use without including long-term care were lower in the intervention group (RR 0.81, 95% CI 0.68–0.99). Conclusions The FINGER intervention has a potential to reduce the need for the inpatient hospital care and emergency visits and associated costs, especially among men.

中文翻译：

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多领域生活方式干预对医疗保健服务使用和成本的影响 - 芬兰预防认知障碍和残疾老年干预研究 （FINGER） 的二次分析：一项随机对照试验


背景 芬兰预防认知障碍和残疾的多领域生活方式干预研究 （FINGER， N = 1259） 是一项随机对照试验，对老年人的发病率有有益影响，但这种生活方式干预在多大程度上会影响医疗保健服务的使用及其成本，尤其是长期影响尚不清楚。目的 本研究调查了 8 年随访期间为期 2 年的 FINGER 多域干预对医疗保健服务使用的影响。还评估了服务使用的成本。方法 分析 FINGER 参与者从国家医疗保健登记册获得的医疗保健服务使用情况 （住院和长期护理天数、急诊就诊次数、门诊医院、家庭护理、初级保健医生和初级保健护士）。试验针对 60-77 岁有认知障碍风险的社区居民，他们被随机分配到多域干预组或对照组。成本被评估为所用服务的平均成本。结果 干预组和对照组之间的总医疗保健成本无显著差异。然而，干预组的参与者对医院住院护理 （RR 0.73， 95% CI 0.54–1.00） 和紧急服务 （RR 0.83， 95% CI 0.70–0.97） 的使用率低于对照组。医院住院护理较低，尤其是男性。各组之间对其他类型医疗保健服务的使用没有差异。干预组不包括长期护理的卫生保健服务使用成本较低（RR 0.81,95% CI 0.68–0.99）。 结论 FINGER 干预有可能减少住院护理和急诊就诊的需求以及相关费用，尤其是在男性中。