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 .
Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 2: Controlled trial in multiple centres
Abstract Objectives : To assess the effectiveness of trained nurses based in general practice s individually prescribing a home exercise programme to reduce  falls and injuries in elderly people and to estimate the cost effectiveness of the programme . Design : Controlled trial with one year 's follow up . Setting : 32 general practice s in seven southern New Zeal and centres . Participants : 450 women and men aged 80 years and older . Intervention : 330 participants received the  exercise programme ( exercise centres ) and 120 received usual care ( control centres ) ; 87 % ( 371 of 426 ) completed the trial . Main outcome measures : Number of falls , number of injuries result ing from falls , costs of implementing the programme , and hospital costs as a result of falls . Results : Falls were reduced by 30 % in the exercise centres ( incidence rate ratio 0.70 , 95 % confidence interval 0.59 to 0.84 ) . The programme was equally effective in men and women . The programme cost $ NZ418 ( £ 121 ) ( at 1998 prices ) per person to deliver for one year or $ NZ1519 ( £ 441 ) per fall prevented . Fewer participants had falls result ing in injuries , but there was no difference in the number who had serious injuries and no difference in hospital costs result ing from falls in exercise centres compared with control centres . Conclusions : An individually tailored exercise programme , delivered by trained nurses from within general practice s , was effective in reducing falls in three different centres . This strategy should be combined with other successful interventions to form part of home programmes to prevent falls in elderly people
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 .