Tambor Marzena, Pavlova Milena, Golinowska Stanisława, Arsenijevic Jelena, Groot Wim
Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Collegium Medicum Krakow, Krakow, Poland.
Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
BMC Health Serv Res. 2016 Sep 5;16 Suppl 5(Suppl 5):426. doi: 10.1186/s12913-016-1517-0.
To motivate people to lead a healthier life and to engage in disease prevention, explicit financial incentives, such as monetary rewards for attaining health-related targets (e.g. smoking cessation, weight loss or increased physical activity) or disincentives for reverting to unhealthy habits, are applied. A review focused on financial incentives for health promotion among older people is lacking. Attention to this group is necessary because older people may respond differently to financial incentives, e.g. because of differences in opportunity costs and health perceptions. To outline how explicit financial incentives for healthy lifestyle and disease prevention work among older persons, this study reviews the recent evidence on this topic.
We applied the method of systematic literature review and we searched in PUBMED, ECONLIT and COCHRANE LIBRARY for studies focused on explicit financial incentives targeted at older adults to promote health and stimulate primary prevention as well as screening. The publications selected as relevant were analyzed based on directed (relational) content analysis. The results are presented in a narrative manner complemented with an appendix table that describes the study details. We assessed the design of the studies reported in the publications in a qualitative manner. We also checked the quality of our review using the PRISMA 2009 checklist.
We identified 15 studies on the role of explicit financial incentives in changing health-related behavior of older people. They include both, quantitative studies on the effectiveness of financial rewards as well as qualitative studies on the acceptability of financial incentives. The quantitative studies are characterized by a great diversity of designs and provide mixed results on the effects of explicit financial incentives. The results of the qualitative studies indicate limited trust of older people in the use of explicit financial incentives for health promotion and prevention.
More research is needed on the effects of explicit financial incentives for prevention and promotion among older people before their broader use can be recommended. Overall, the design of the financial incentive system may be a crucial element in their acceptability.
为激励人们过上更健康的生活并参与疾病预防，人们采用了明确的经济激励措施，例如对实现与健康相关目标（如戒烟、减肥或增加体育活动）给予金钱奖励，或对恢复不健康习惯进行惩罚。目前缺乏针对老年人健康促进经济激励措施的综述。关注这一群体很有必要，因为老年人对经济激励的反应可能不同，例如由于机会成本和健康认知的差异。为了概述明确的经济激励措施在老年人健康生活方式和疾病预防方面的作用，本研究回顾了关于这一主题的最新证据。
我们采用系统文献综述方法，在PubMed、ECONLIT和Cochrane图书馆中搜索专注于针对老年人的明确经济激励措施以促进健康、刺激一级预防和筛查的研究。对选定的相关出版物基于定向（关系）内容分析进行分析。结果以叙述方式呈现，并辅以描述研究细节的附录表。我们以定性方式评估出版物中报告的研究设计。我们还使用PRISMA 2009清单检查了综述的质量。
我们确定了15项关于明确经济激励措施在改变老年人健康相关行为中作用的研究。它们包括关于经济奖励有效性的定量研究以及关于经济激励措施可接受性的定性研究。定量研究的特点是设计差异很大，并且在明确经济激励措施的效果方面提供了混合结果。定性研究结果表明，老年人对使用明确经济激励措施促进健康和预防的信任有限。
在推荐更广泛使用明确经济激励措施促进老年人预防和健康之前，需要对其效果进行更多研究。总体而言，经济激励系统的设计可能是其可接受性的关键因素。
