---
type: source
title: "Health Economics of Social Prescribing: Systematic Review Finds Positive SROI but 'Robust Economic Evidence Remains Limited'"
author: "Various (Frontiers in Public Health)"
url: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1753435/full
date: 2026-01-01
domain: health
secondary_domains: []
format: paper
status: null-result
priority: medium
triage_tag: claim
tags: [social-prescribing, health-economics, cost-effectiveness, evidence-quality, international-health-systems]
processed_by: vida
processed_date: 2026-03-18
extraction_model: "anthropic/claude-sonnet-4.5"
extraction_notes: "LLM returned 1 claims, 1 rejected by validator"
---

## Content

Systematic review of health economics evidence on social prescribing. 18 studies met inclusion criteria: 5 RCTs, 1 quasi-experimental, 12 mixed-methods. Searched seven databases plus gray literature.

Geographic coverage: England, Wales, Ireland, Europe, Australia, New Zealand, Canada, USA.

Intervention types analyzed:
- Exercise-based or loneliness-prevention (n=10)
- Coaching programs (n=3)
- Nature-based interventions (n=3)
- Dance/movement-based (n=2)

Economic findings:
- Social Return on Investment (SROI): positive returns for mental health and loneliness interventions
- SROI ratios: £1.17 to £7.08 per £1 invested
- Financial ROI: only 0.11 to 0.43 per £1 invested (much lower than SROI)
- Standard health economic methods (CEA, CUA, CBA) "rarely applied"

Key conclusion: "Robust economic evidence on social prescribing remains limited. Despite the availability of established health economic methods and tools, these are rarely applied to social prescribing, limiting the usefulness of existing studies for healthcare planning and commissioning."

Major limitations: absence of standardized outcome measures, inconsistent definitions across models, inadequate evaluation frameworks preventing cross-setting comparisons.

Complementary evidence on healthcare utilization (from separate reviews):
- 28% average reduction in GP demand (range: 2-70%)
- 24% average reduction in A&E attendance (range: 8-27%)
- BUT: 15 of 17 utilization studies were uncontrolled before-and-after designs
- Mean attrition rate: 38%

## Agent Notes
**Triage:** [CLAIM] — Social prescribing's economic evidence is thin despite massive scale, with SROI consistently positive but financial ROI below 1.0 per £1 — suggesting social value exceeds healthcare cost savings
**Why this matters:** The SROI vs. financial ROI gap is telling: social prescribing produces social value (wellbeing, connectedness, reduced isolation) that SROI captures but financial ROI doesn't. This means social prescribing may be worthwhile from a societal perspective but NOT cost-saving for healthcare payers — a critical distinction for scaling decisions.
**What surprised me:** Financial ROI of 0.11-0.43 per £1. Social prescribing may actually COST money from a healthcare budget perspective, even as it improves wellbeing. This is the opposite of the CHW story ($2.47 ROI). The implication: not all non-clinical interventions are created equal for healthcare payer economics.
**KB connections:** [[SDOH interventions show strong ROI but adoption stalls...]], [[social isolation costs Medicare 7 billion annually...]]
**Extraction hints:** Claim candidate: "Social prescribing produces measurable social value (SROI £1.17-£7.08 per £1) but does not reliably produce healthcare cost savings (financial ROI 0.11-0.43 per £1), making its scaling dependent on who bears the cost and who captures the value"

## Curator Notes
PRIMARY CONNECTION: social isolation costs Medicare 7 billion annually and carries mortality risk equivalent to smoking 15 cigarettes per day making loneliness a clinical condition not a personal problem
WHY ARCHIVED: Provides the economic evidence (or lack thereof) for social prescribing, the most scaled non-clinical health intervention globally. The SROI/financial ROI divergence is a key finding for understanding which behavioral health interventions can scale under healthcare payment models.


## Key Facts
- Social prescribing systematic review included 18 studies: 5 RCTs, 1 quasi-experimental, 12 mixed-methods
- Geographic coverage: England, Wales, Ireland, Europe, Australia, New Zealand, Canada, USA
- Intervention types: exercise/loneliness prevention (n=10), coaching (n=3), nature-based (n=3), dance/movement (n=2)
- SROI ratios ranged from £1.17 to £7.08 per £1 invested
- Financial ROI ranged from 0.11 to 0.43 per £1 invested
- 28% average reduction in GP demand (range: 2-70%)
- 24% average reduction in A&E attendance (range: 8-27%)
- 15 of 17 utilization studies were uncontrolled before-and-after designs
- Mean attrition rate across studies: 38%
