Cost-effectiveness of comprehensive geriatric assessment: systematic review of economic evaluations.

Authors

Amanuel Lulu Yigezu, Christina Hayes, Rose Galvin, Dominic Trépel

Published in

Age and ageing. Volume 55. Issue 7. Jul 02, 2026.

Abstract

Comprehensive geriatric assessment (CGA) can be resource-intensive as its delivery involves multidisciplinary personnel, multidimensional assessment, care planning and follow-up. The aim of this systematic review is to appraise and synthesise evidence on the cost-effectiveness of CGA across settings.
Full economic evaluation studies examining CGA were searched across five databases. We included studies involving adults aged ≥65 years who were identified as living with frailty or at risk of adverse outcomes. Two independent reviewers screened studies against eligibility criteria and extracted data using a pretested extraction form. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards framework. We reported the results through narrative summaries, tables and figures.
A total of 4864 studies were identified, of which 17 were included across 7 settings (11 community, 6 hospital). Of 13 cost-utility analysis studies, incremental quality-adjusted life years ranged from -0.06 to 0.54 and incremental costs ranged from €-12 744 to €29 785. The probability CGA was cost-effective ranged from 0% to 98.9% across stated willingness-to-pay thresholds (cost-effective in 5/13, not cost-effective in 7/13, 50% chance in 1/13). Two studies showed that cost-effectiveness can vary by frailty severity and residential status. The resource intensity of CGA varied, ranging from 25% (case management protocol) to 81% (comprehensive assessment). Only five studies accounted for informal caregiver costs. The reporting quality ranged from 38% to 90%.
The cost-effectiveness of CGA remains uncertain. Variations in resource intensity of CGA, frailty severity, residential status of older adults and setting may explain this heterogeneity.
CRD42023492586.

PMID:
42437530
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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