PDF(Pubmed)
Abstract：
BACKGROUND: Asset-based approaches (ABAs) tackle health inequalities by empowering people in more disadvantaged communities, or targeted populations, to better utilise pre-existing local community-based resources. Using existing resources supports individuals to better manage their own health and its determinants, potentially at low cost. Targeting individuals disengaged with traditional service delivery methods offers further potential for meaningful cost-savings, since these people often require costly care. Thus, improving prevention, and management, of ill-health in these groups may have considerable cost implications.
OBJECTIVE: To systematically review the extent of current cost and economic evidence on ABAs, and methods used to develop it.
METHODS: Search strategy terms encompassed: i) costing; ii) intervention detail; and iii) locality. Databases searched: Medline, CENTRAL and Wed of Science. Researchers screened 9,116 articles. Risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) tool. Narrative synthesis summarised findings.
RESULTS: Twelve papers met inclusion criteria, representing eleven different ABAs. Within studies, methods varied widely, not only in design and comparators, but also in terms of included costs and outcome measures. Studies suggested economic efficiency, but lack of suitable comparators made more definitive conclusions difficult.
CONCLUSIONS: Economic evidence around ABAs is limited. ABAs may be a promising way to engage underserved or minority groups, that may have lower net costs compared to alternative health and wellbeing improvement approaches. ABAs, an example of embedded services, suffer in the context of economic evaluation, which typically consider services as mutually exclusive alternatives. Economics of the surrounding services, mechanisms of information sharing, and collaboration underpin the success of assets and ABAs. The economic evidence, and evaluations in general, would benefit from increased context and detail to help ensure more nuanced and sophisticated understanding of the economics of ABAs. Further evidence is needed to reach conclusions about cost-effectiveness of ABAs.
OBJECTIVE: To systematically review the extent of current cost and economic evidence on ABAs, and methods used to develop it.
METHODS: Search strategy terms encompassed: i) costing; ii) intervention detail; and iii) locality. Databases searched: Medline, CENTRAL and Wed of Science. Researchers screened 9,116 articles. Risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) tool. Narrative synthesis summarised findings.
RESULTS: Twelve papers met inclusion criteria, representing eleven different ABAs. Within studies, methods varied widely, not only in design and comparators, but also in terms of included costs and outcome measures. Studies suggested economic efficiency, but lack of suitable comparators made more definitive conclusions difficult.
CONCLUSIONS: Economic evidence around ABAs is limited. ABAs may be a promising way to engage underserved or minority groups, that may have lower net costs compared to alternative health and wellbeing improvement approaches. ABAs, an example of embedded services, suffer in the context of economic evaluation, which typically consider services as mutually exclusive alternatives. Economics of the surrounding services, mechanisms of information sharing, and collaboration underpin the success of assets and ABAs. The economic evidence, and evaluations in general, would benefit from increased context and detail to help ensure more nuanced and sophisticated understanding of the economics of ABAs. Further evidence is needed to reach conclusions about cost-effectiveness of ABAs.
摘要：
背景：基于资产的方法（ABAs）通过赋予更弱势社区的人们权力来解决健康不平等问题，或目标人群，更好地利用现有的本地社区资源。利用现有资源支持个人更好地管理自己的健康及其决定因素，潜在的低成本。针对与传统服务提供方法脱节的个人，可以进一步节省有意义的成本。因为这些人通常需要昂贵的护理。因此，加强预防,和管理,这些群体的健康状况不佳可能会产生相当大的成本影响。
目标：为了系统地审查当前成本和经济证据对ABAs的影响程度，以及开发它的方法。
方法：搜索策略术语包括：i）成本计算；ii）干预细节；iii）地区。搜索的数据库:Medline,CENTRALandWedofScience.研究人员筛选了9116篇文章。使用关键评估技能计划（CASP）工具评估偏差风险。叙事综合总结了研究结果。
结果：12篇论文符合纳入标准，代表11个不同的ABAs。在研究中，方法多种多样，不仅在设计和比较方面，但也包括成本和结果措施。研究表明经济效率，但是缺乏合适的比较器使更明确的结论变得困难。
结论：围绕ABAs的经济证据有限。ABA可能是一种有希望的方式，可以让服务不足或少数群体参与进来，与替代健康和福祉改善方法相比，这可能具有更低的净成本。ABAs,嵌入式服务的一个例子，在经济评估的背景下受苦，它们通常认为服务是相互排斥的替代品。周围服务的经济学，信息共享机制，和合作是资产和ABA成功的基础。经济证据,和总体评估，将受益于更多的背景和细节，以帮助确保对ABA的经济学有更细致入微的理解。需要进一步的证据来得出关于ABAs成本效益的结论。
目标：为了系统地审查当前成本和经济证据对ABAs的影响程度，以及开发它的方法。
方法：搜索策略术语包括：i）成本计算；ii）干预细节；iii）地区。搜索的数据库:Medline,CENTRALandWedofScience.研究人员筛选了9116篇文章。使用关键评估技能计划（CASP）工具评估偏差风险。叙事综合总结了研究结果。
结果：12篇论文符合纳入标准，代表11个不同的ABAs。在研究中，方法多种多样，不仅在设计和比较方面，但也包括成本和结果措施。研究表明经济效率，但是缺乏合适的比较器使更明确的结论变得困难。
结论：围绕ABAs的经济证据有限。ABA可能是一种有希望的方式，可以让服务不足或少数群体参与进来，与替代健康和福祉改善方法相比，这可能具有更低的净成本。ABAs,嵌入式服务的一个例子，在经济评估的背景下受苦，它们通常认为服务是相互排斥的替代品。周围服务的经济学，信息共享机制，和合作是资产和ABA成功的基础。经济证据,和总体评估，将受益于更多的背景和细节，以帮助确保对ABA的经济学有更细致入微的理解。需要进一步的证据来得出关于ABAs成本效益的结论。
