Schmidt Steven M, Chiatti Carlos, Ekstam Lisa, Haak Maria, Heller Christina, Nilsson Maria H, Slaug Björn
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
R&D Unit, Tech4Care srl, Falconara Marittima, Italy.
JMIR Res Protoc. 2022 Aug 12;11(8):e39032. doi: 10.2196/39032.
Policies that promote aging in place are common in Sweden and many other countries. However, the current housing stock cannot sufficiently accommodate a population aging in place considering how functional capacity and housing needs change as people age. To be suitable for all regardless of their functional ability, housing should be designed or adapted to facilitate the performance of activities of daily living. Long-term planning and plausible projections of development 20 to 30 years into the future are needed.
The overall aim is to develop simulation models that enable long-term predictions and analysis of potential consequences in terms of societal gains and costs for different large-scale measures and interventions in the ordinary housing stock.
This study is designed as a simulation study and will broadly apply health impact assessment methods in collaboration with five municipalities in Sweden. Individual interviews and research circles were used to identify current and prioritize potential new policies to improve the accessibility of the housing stock. We will run a series of simulations based on an estimated willingness to pay from discussions with the municipalities. Two to three different prioritized policies will be compared simultaneously using Markov cohort analysis to estimate the potential costs and health impact on the population. Using data from a systematic review and existing population-based data sets with individual-level data on home and health variables, we will calculate parameter estimates for the relations between housing accessibility and health outcomes. The potential impact of selected policy interventions will be estimated in several microsimulations representing people living in the community. Sensitivity analyses will be conducted for each simulation.
As of April 2022, open access data was collected, and a systematic review was underway and expected to be completed by November 2022. Collaboration with five municipalities was established in autumn 2020. In spring 2021, the municipalities developed a list of prioritized policy interventions to be tested and used in the simulation models. Inventories of barrier frequencies in ordinary housing started in spring 2022 and are expected to be completed in autumn 2022. Data gathering and analyses for simulation inputs will be completed during 2022 followed by the simulation modeling analyses to be completed in 2023.
Improved accessibility of the ordinary housing stock has the potential to maintain or improve the health of the aging population. This study will generate tools that enable long-term predictions and reliable cost-benefit estimates related to the housing adaptation needs for a population aging in place, thus providing support for the best-informed policy decisions.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39032.
促进就地养老的政策在瑞典和许多其他国家很常见。然而，考虑到随着人们年龄增长功能能力和住房需求的变化，当前的住房存量不足以充分容纳就地养老的人口。为了适合所有人，无论其功能能力如何，住房都应进行设计或改造，以方便日常生活活动的开展。需要进行长期规划以及对未来20至30年的发展进行合理预测。
总体目标是开发模拟模型，以便对普通住房存量中不同大规模措施和干预措施的社会收益和成本方面的潜在后果进行长期预测和分析。
本研究设计为模拟研究，将与瑞典的五个城市合作广泛应用健康影响评估方法。通过个人访谈和研究小组来确定当前的潜在新政策并对其进行优先级排序，以改善住房存量的可达性。我们将根据与各城市讨论得出的估计支付意愿进行一系列模拟。将同时使用马尔可夫队列分析比较两到三项不同的优先政策，以估计对人口的潜在成本和健康影响。利用系统评价的数据和现有的基于人群的数据集，其中包含关于家庭和健康变量的个体层面数据，我们将计算住房可达性与健康结果之间关系的参数估计值。将在代表社区居民的多个微观模拟中估计所选政策干预措施的潜在影响。将对每个模拟进行敏感性分析。
截至2022年4月，已收集公开数据，正在进行系统评价，预计2022年11月完成。2020年秋季与五个城市建立了合作关系。2021年春季，各城市制定了一份优先政策干预措施清单，用于在模拟模型中进行测试和使用。普通住房中障碍频率的清查于2022年春季开始，预计2022年秋季完成。模拟输入的数据收集和分析将在2022年完成，随后的模拟建模分析将于2023年完成。
改善普通住房存量的可达性有可能维持或改善老年人口的健康。本研究将生成工具，能够对就地养老人口的住房改造需求进行长期预测和可靠的成本效益估计，从而为最明智的政策决策提供支持。
国际注册报告识别号（IRRID）：DERR1-10.2196/39032。
