Engel Lidia, Rizal Muhammad Fikru, Clifford Sharon, Faller Jan, Lim Michelle H, Le Long Khanh-Dao, Chatterton Mary Lou, Mihalopoulos Cathrine
Faculty of Medicine Nursing and Health Sciences, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia.
Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
Pharmacoeconomics. 2025 Jun 16. doi: 10.1007/s40273-025-01516-w.
There has been growing interest in understanding the economic impacts of loneliness and social isolation. This study updates a previous review on the economic costs of loneliness and social isolation and the cost effectiveness of related interventions.
We conducted a systematic search in the MEDLINE, PsycInfo, CINAHL, and Embase databases from 2018 to 13 August 2024, supplemented by a search of the grey literature. Studies included cost-of-illness studies, economic evaluations, and social return on investment (SROI) analyses published in the English language. All studies were evaluated for quality and summarised using a narrative approach. Costs reported were converted into US$, year 2024 values.
In total, 15 studies were included: six cost-of-illness studies, four economic evaluations, and five SROI studies. Cost-of-illness studies primarily examined healthcare and productivity costs. All but one study reported excess costs linked to loneliness and social isolation, ranging from US$2 billion to US$25.2 billion per annum. Among four economic evaluations, three were model-based cost-utility or cost-effectiveness analyses (targeting older adults and the general population), and one was trial based (focusing on low-income individuals with health issues). One study found an intervention cost effective, whereas cost-effectiveness probabilities in others ranged from 54% to 68%. One study concluded that an intervention to reduce severe loneliness in older adults was cost effective but unlikely to be cost saving. All SROI studies reported positive returns, with SROI ratios ranging from US$2.28 to US$13.72.
This review highlights additional evidence on the economic burden of loneliness and social isolation. Future research should explore broader cost impacts beyond healthcare and expand cost-effectiveness studies to younger populations.
人们对了解孤独和社会隔离的经济影响的兴趣与日俱增。本研究更新了之前关于孤独和社会隔离的经济成本以及相关干预措施的成本效益的综述。
我们在2018年至2024年8月13日期间对MEDLINE、PsycInfo、CINAHL和Embase数据库进行了系统检索，并辅以灰色文献检索。纳入的研究包括以英文发表的疾病成本研究、经济评估和社会投资回报率（SROI）分析。所有研究都进行了质量评估，并采用叙述性方法进行总结。报告的成本已换算为2024年的美元价值。
总共纳入了15项研究：6项疾病成本研究、4项经济评估和5项SROI研究。疾病成本研究主要考察了医疗保健和生产力成本。除一项研究外，所有研究均报告了与孤独和社会隔离相关的额外成本，每年从20亿美元到252亿美元不等。在四项经济评估中，三项是基于模型的成本效用或成本效益分析（针对老年人和普通人群），一项是基于试验的（关注有健康问题的低收入个体）。一项研究发现一种干预措施具有成本效益，而其他研究中的成本效益概率在54%至68%之间。一项研究得出结论，一项减少老年人严重孤独感的干预措施具有成本效益，但不太可能节省成本。所有SROI研究均报告了正回报，SROI比率从2.28美元到13.72美元不等。
本综述突出了关于孤独和社会隔离经济负担的更多证据。未来的研究应探索医疗保健之外更广泛的成本影响，并将成本效益研究扩展到更年轻的人群。
