In 2004, Munro, et. al., conducted study to evaluate the cost effectiveness of a community-based exercise program targeting older adults as a population-wide public health initiative.

This study employed a pragmatic, cluster-randomized community intervention trial design, conducted across 12 general practices in Sheffield. Four practices were randomly assigned as intervention populations, while eight served as control populations.

The study enrolled individuals aged 65 and above from the least active four-fifths of the population, as determined by a baseline survey. A total of 2,283 eligible participants were included from intervention practices, and 4,137 from control practices.

Eligible participants were invited to attend locally held exercise classes, provided free of charge over a two-year period.

The study assessed all-cause and exercise-related cause-specific mortality, hospital service utilization at two years, and health status measured at baseline, one year, and two years using the SF-36 questionnaire. A cost-utility analysis was also conducted.

Approximately 26% of eligible participants from intervention practices attended one or more exercise sessions. The study found no significant differences in mortality rates, survival times, or hospital admissions between intervention and control groups. However, after adjusting for baseline characteristics, individuals in intervention practices exhibited a lower decline in health status, with significance noted in the energy dimension and two composite scores (p<0.05). The incremental average gain of 0.011 Quality-Adjusted Life Years (QALYs) per person in the intervention group resulted in an incremental cost per QALY ratio of 17,174 (95% CI = 8,300 to 87,120).

Despite relatively low adherence to the exercise program, notable improvements in health-related quality of life were observed. The program demonstrated greater cost-effectiveness compared to many existing medical interventions and is deemed practical for implementation by primary care commissioning agencies.

Reference: Munro, J. F., Nicholl, J. P., Brazier, J. E., Davey, R., & Cochrane, T. (2004). Cost effectiveness of a community based exercise programme in over 65 year olds: cluster randomised trial. Journal of Epidemiology & Community Health, 58(12), 1004-1010.