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 .
Breaking bones, breaking budgets: a clinical and economic evaluation of a prospective, randomized, practice controlled, intervention study in the prevention of accidents in primary care.
OBJECTIVE This longitudinal study was design ed to assess the effect of an educational training package for primary health care teams in accident prevention for older people , with reference to the incidence of accidents and their associated economic consequence . METHODS Nineteen general practice s in the West Midl and s serving a population of 138 397 were allocated r and omly at the practice level either to receive  training  or continue normal practice . Study data was collated from the initial telephone call , reporting an accident , to the surgery , advice/treatment given at the practice and /or the community , casualty , inpatient care , written correspondence to the patient 's GP and any subsequent follow-up visits for accidents to people aged 65 years or older . RESULTS One thous and , six hundred and sixty-six ( 8.2 % ) patients aged 65 years or older registered with the participating practice s experienced one accident or more , costing the NHS pound 1.4 million . Extrapolated nationally , annual costs to the NHS for accidents to older people amount to pound 568 million . The educational package had no significant impact on the incidence of accidents . A paucity of general safety advice was given [ 48 ( 1.8 % ) occasions ] . CONCLUSIONS Budgets are being eroded and patients are suffering unnecessarily due to lack of accident prevention advice . This should be considered a priority within the primary health care team . Educational packages alone do not appear to be a cost-effective approach to accident prevention in primary care
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 .