Economic evidence related to the use of community assets in the management of frailty: a systematic review.

Authors

Mohammed G H Sammour, Helen P French, Suzanne McDonough, Llinos Haf Spencer, Mary Lynch

Published in

Frontiers in public health. Volume 14. Pages 1874340. Epub Jul 09, 2026.

Abstract

Frailty is characterized by multisystem dysregulations leading to reduced physiological reserve with greater vulnerability to morbidity and mortality. Community asset interventions have emerged as multidimensional approaches to supporting people with frailty that improve quality of life, strengthen social bonds, and promote wellbeing. While community participation is associated with a higher quality of life, robust evidence on the economic effectiveness of these approaches in populations with or at risk of frailty remains scarce.
A systematic review was conducted following PRISMA 2020 guidelines and registered on PROSPERO. Five databases were searched from January 2000 to August 2025. Two reviewers screened titles, abstracts, and full texts using the Covidence systematic review management software. A narrative synthesis was conducted following Synthesis without Meta-analysis (SWiM) guidelines.
Twelve studies were included in the review. Five studies were cost-effectiveness analyses (CEA), three applied cost-consequence analyses (CCA), three investigated healthcare resource utilization (HRU)/modeling, and one applied cost-benefit analysis (CBA). Results varied according to methodology, outcome measures, and follow-up periods. In the CEA studies, four interventions were reported as dominant (less costly and more effective than usual care). CCA and HRU/modeling evidence reported inconsistent findings but indicated cost reductions through fewer hospitalizations and delayed transitions to long-term care. A modeling study predicted cost neutrality within 5-7 months and substantial 5-year savings. CBA evidence was limited, as only one study was included.
While multi-component community assets offer potential economic benefits over usual care for frailty management, weak evidence and methodological inconsistencies preclude definitive conclusions. High-quality, future research utilizing standardized economic frameworks and, population-specific outcome tools are needed to inform policy and resource allocation decisions.
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251018547, CRD420251018547.

PMID:
42494894
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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