Disregarding these method ological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and , hence , an age-based rationing of public health care
Background In the light of demographic developments health promotion interventions for older people are gaining importance .
In addition to method ological challenges arising from the economic evaluation of health promotion interventions in general , there are specific method ological problems for the particular target group of older people .
There are especially four main method ological challenges that are discussed in the literature .
They concern measurement and valuation of informal caregiving , accounting for productivity costs , effects of unrelated cost in added life years and the inclusion of ‘ beyond-health ’ benefits .
This paper focuses on the question whether and to what extent specific method ological requirements are actually met in applied health economic evaluations .
Cost-effectiveness of a multifactorial fall prevention program in nursing homes
Summary The purpose of this study was to analyze the cost-effectiveness of a multifactorial fall prevention program in nursing home residents . Given a willingness-to-pay ( WTP ) of 50,000 EUR per year free of femoral fracture , the probability that the intervention is cost-effective is 83 % . Introduction Despite their increased risk of falls and fractures , nursing home residents have been neglected in economic evaluations of fall prevention programs so far . The purpose of this study was to analyze , for the first time , the cost-effectiveness of a multifactorial fall prevention program in nursing home residents . Methods This study is part of a prospect i ve , unblinded , cluster , nonr and omized , controlled study focusing on the transfer of an efficacious fall prevention program into a real-world setting . The analyzed sub sample was derived from cl aims data and consisted of data on intervention ( n = 256 , residents n = 10,178 ) and control homes ( n = 893 , residents n = 22,974 ) , representing all insurants of a sickness fund ( AOK Bavaria , Germany ) who were 65 years or older , residing in a nursing home on the 31st of March 2007 and had a level of care of ≥1 according to the classification of the statutory long-term care insurance . Time free of femoral fracture ( ICD-10 , S72 ) was used as measure of health effects . Femoral fracture-related costs and intervention costs were measured from a payer perspective . Multivariate regression models were applied . Sensitivity analyses were performed and cost-effectiveness acceptability curves computed . Results Within the first year of the intervention , femoral fracture rate was significantly reduced , result ing in a nonsignificant incremental mean time of 1.41 days free of femoral fracture . Incremental mean total direct costs were 29 EUR per resident , which was not significant . The incremental cost-effectiveness ratio ( ICER ) was 7,481 EUR per year free of femoral fracture . The probability of an ICER < 50,000 EUR per year free of femoral fracture was 83 % . Conclusion Depending on the amount the decision-maker is willing to pay for the incremental effect , the fall prevention program might be cost-effective within the first year . Future studies should exp and the range of costs and effects measured
Disregarding these method ological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and , hence , an age-based rationing of public health care
Background In the light of demographic developments health promotion interventions for older people are gaining importance .
In addition to method ological challenges arising from the economic evaluation of health promotion interventions in general , there are specific method ological problems for the particular target group of older people .
There are especially four main method ological challenges that are discussed in the literature .
They concern measurement and valuation of informal caregiving , accounting for productivity costs , effects of unrelated cost in added life years and the inclusion of ‘ beyond-health ’ benefits .
This paper focuses on the question whether and to what extent specific method ological requirements are actually met in applied health economic evaluations .