Simulation models that enable long-term predictions and cost-benefit analysis related to housing adaptation needs for a population ageing in place: Study Protocol (Preprint)

BACKGROUND Policies that promote ageing in place are common in Sweden and many other countries. To be suitable for all regardless of functional ability, housing should be designed or adapted in such a way that it facilitates the performance of activities of daily living. The current housing stock cannot sufficiently accommodate a population aging in place, and long-term planning and plausible projections of development 20-30 years into the future are needed. OBJECTIVE 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. METHODS This study is designed as a simulation study and will broadly apply health impact assessment methods in collaboration with several municipalities in Sweden. Individual interviews and research circles were used to identify 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 existing datasets with individual level data on home and health variables, we will also conduct several microsimulations representing those living in the community. Sensitivity analyses will be conducted for each simulation. RESULTS As of April 2022, open access data is collected, a systematic review is underway, and collaboration with five municipalities is ongoing including a list of prioritized policy level interventions. Data gathering and analysis for simulation inputs will be completed during 2022 followed by the simulation modelling analyses to be completed in 2023. CONCLUSIONS Improved accessibility of the ordinary housing stock has the potential to maintain or improve the health of our ageing 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 ageing in place, thus providing support for the best-informed policy decisions.