BACKGROUND: The role of Comprehensive Geriatric Assessment (CGA) is crucial from a clinical point of view for frail older patients, permitting tailored interventions that may address specific needs. In addition to its clinical significance, understanding the economic value of CGA is also essential. Cost-effectiveness analyses are increasingly conducted to evaluate health interventions, but the literature about CGA is still limited, and no comprehensive overview is currently available. The aim of our study is therefore to systematically review economic evaluations of CGA, including both cost analyses and cost-effectiveness analyses, to provide the most complete overview of the available evidence. METHODS: We searched several databases from database inception to 01st January 2025. We included studies that reported costs and/or cost-effectiveness of CGA compared to usual care. The characteristics and results of included studies were summarized using a narrative summary that compared and evaluated the methods used and the principal results among studies. FINDINGS: Among 3,839 articles initially screened, 36 studies with a total of 68,186 older people (mean age: 79 years old) followed on average for two years were included. Overall, 17 studies evaluated cost analysis, with 13 studies with lower cost in CGA group and 4 studies with higher cost. Similarly, 19 studies evaluated cost-effectiveness, among these 12 had Quality-Adjusted Life Years (QALYs) as outcome of which seven were dominant (lower costs for better health outcomes), and two were cost-effective. Finally, 7 studies assessed other outcomes than QALYs, with dominance achieved in five of them. CONCLUSION: CGA appears to have the potential to be cost-effective in several settings, with many studies reporting favorable economic outcomes. Overall, CGA shows promise as an effective and cost-effective intervention, but further research with longer follow-up and a broader range of economic models is needed to fully assess its economic value.
Pilotto et al. (2026) studied this question.