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67. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 13. Jahreskongress der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e. V. (TMF)

21.08. - 25.08.2022, online

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Economic Evaluations on Nature-Based Social Prescribing for Health Improvement: A Systematic Overview

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  • Igor Stojkov - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Marjan Arvandi - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Felicitas Kühne - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Annette Conrads-Frank - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Sibylle Puntscher - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Daniela Schmid - Division for Quantitative Methods in Public Health and Health Services Research, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sc, Hall in Tirol, Austria
  • Beate Jahn - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
  • Erica Aranha Suzumura - Department of Preventive Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Richard Kimberlee - Faculty of Health and Life Sciences, University of the West of England, Bristol, United Kingdom
  • Kaisu Pitkälä - Department of General Practice and Helsinki University Hospital, Unit of Primary Care, University of Helsinki, Helsinki, Finland
  • Anu Jansson - Department of General Practice and Helsinki University Hospital, Unit of Primary Care, University of Helsinki, Helsinki, Finland
  • Laura Coll-Planas - Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University o, Vic, Spain
  • Jill S. Litt - Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
  • Uwe Siebert - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; Division of Health Technology Assessment, ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria; Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard Chan School of Public Health, Boston, United States; Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, United States
  • Ursula Rochau - Institute of Public Health, Medical Decision Making and HTA, Department of Public Health, Health Services Research and HTA, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 67. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS), 13. Jahreskongress der Technologie- und Methodenplattform für die vernetzte medizinische Forschung e.V. (TMF). sine loco [digital], 21.-25.08.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAbstr. 131

doi: 10.3205/22gmds135, urn:nbn:de:0183-22gmds1354

Veröffentlicht: 19. August 2022

© 2022 Stojkov et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Text

Introduction: Non-medical issues primarily related to social problems represent a significant portion of primary care admissions and impose serious economic and organizational burden on health care systems [1], [2]. In the past years, social prescribing (SP) services are implemented as a promising strategy, particularly in the United Kingdom (UK) [1]. SP enables general practitioners or professional workers to link vulnerable groups of people with respective community groups to provide holistic social care and to support personalized treatment, well-being, and quality of life [3]. SP encompasses a wide range of services, including socioeconomic consulting, emotional support, charity work, and exercise classes. A valuable SP subset is nature-based social prescribing (NBSP) including various inclusive, green activities (e.g., group gardening, outdoor exercise) [4], [5]. Still, the evidence of the health economic impact of SP remains unclear. The aim of our systematic literature review is to provide an overview of health economic aspects of NBSP.

Methods: We performed a systematic literature search in PubMed/MEDLINE, Embase, INAHTA Database, GH CEA Registry, NHS EED, and EconLit. Two independent reviewers performed the title/abstract and full-text screening of the articles. We included all primary, peer-reviewed original studies with partial or complete economic analyses (e.g., cost analyses, cost minimization analyses, cost-benefit analyses, cost-effectiveness analyses, cost-utility analysis), and NBSP interventions as a main part of the intervention aiming at health improvement in adult population. Studies were included if published in English, German or Spanish after the year 2000. Evidence was extracted with a priori defined extraction forms and summarized in systematic evidence tables. Our work is part of the Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces (RECETAS) project.

Results: From the obtained 2,387 hits, after removal of duplicates and title/abstract screening, three studies fulfilled the inclusion criteria [6], [7], [8].

All three included studies were from UK. Although we found varying study populations, all three studies included people with mild mental disorders [6], [7], [8]. The analyzed time horizon varied between one [6], [7], [8] and ten years [7].

Jones et al. [6] used a social return on investment analyses to combine multiple cost and health-related outcomes of a 16-week NBSP program, resulting in a ratio of 5.07 British pounds (£) returned for one £ invested.

Pretty et al. [7] performed a cost-benefit analysis on a combination of nature-based and mind-body interventions using life satisfaction/happiness as outcome. They concluded economic returns of 6,000-14,000 £ per person after one year, reaching up to 8,600-24,500 £ per person after ten years.

Willis et al. [8] performed a cost-utility study on 12-week woodland activities yielding costs of 8,600 £ per quality-adjusted life year gained.

Conclusion: The evidence on the health economic impact is limited. All three studies showed beneficial health and economic outcomes for implementing NBSP. Study limitations included typical features of complex interventions such as potential associations of benefits with activities external to the study intervention, unclear interactions between heterogeneous intervention features, and uncertainty regarding the effect duration. Therefore, further research is needed based on clear study protocols.

Funding: The work received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 945095 for the project "Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces (RECETAS)".

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.

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References

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