The impact of loneliness on healthcare costs and service utilisation and the cost-effectiveness of loneliness interventions: systematic review

Eager, Sharon, Baldwin, Helen, McDaid, David ORCID: 0000-0003-0744-2664, McCrone, Paul, Barnett, Phoebe, Stefanidou, Theodora, Shah, Prisha, Jeffreys, Stephen, Rojas-García, Antonio, Jarvis, Ruby, Chipp, Beverley, Lloyd-Evans, Brynmor, Pitman, Alexandra, Matias, Maria Ana, Jacob, Nikita and Johnson, Sonia (2025) The impact of loneliness on healthcare costs and service utilisation and the cost-effectiveness of loneliness interventions: systematic review. BJPsych Open, 11 (6). ISSN 2056-4724

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Abstract

Background: Loneliness is associated with several physical and mental health problems, yet its costs to the healthcare system remain unclear. Aims: The current study aimed to review literature on the health and social care impacts of loneliness, and review economic evaluations of loneliness interventions. Method: We conducted a systematic review of studies published from 2008 to April 2025 by searching five bibliographic databases, grey literature and reference lists of systematic reviews. Studies estimating health and social care cost/expenditure, and on health resource utilisation, were included to assess the impact of loneliness on the health system. Return on investment, social return on investment and cost-effectiveness evaluations were included to assess the economic impact of loneliness interventions. We conducted quality appraisal and narrative synthesis of results. Results: We included 53 studies. Eight estimated the healthcare cost/expenditure of loneliness, 33 reported healthcare resource use and 19 were economic evaluations of interventions. Findings relating to the cost/expenditure of loneliness and service use were inconsistent: some studies reported excess costs/expenditure and service use, whereas others found lower costs/expenditure and service use. Economic evaluation studies indicated that loneliness interventions can be cost-effective, but were not consistently cost-saving or effective in reducing loneliness. Conclusions: Findings on the impact of loneliness on the healthcare system and economic evaluations of loneliness interventions were varied. Therefore, we cannot derive confident conclusions from this review. To address evidence gaps, future research relating to social care, younger populations, direct healthcare costs of loneliness and randomised controlled trials with long-term follow-ups should be prioritised.

Item Type:	Article
Additional Information:	© The Author(s), 2025
Divisions:	Care Policy and Evaluation Centre
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine
Date Deposited:	20 Oct 2025 16:04
Last Modified:	20 Oct 2025 18:23
URI:	http://eprints.lse.ac.uk/id/eprint/129876

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