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 preventive home visits to the elderly
We evaluated the cost effectiveness of preventive home visits  to elderly persons in Denmark alongside a 3-year r and omized controlled study . The main outcome measure was incremental costs per active life-year gained . The number of active life-years was defined as those during which the person is able independently to transfer , walk indoors , go outdoors , walk outdoors in both pleasant and poor weather , and climb stairs . In 17 of 34 municipalities health visitors and general practitioners were offered geriatric training , which focused on early signs of disability , physical activity , and interdisciplinary follow-up . The remaining 17 municipalities offered preventive home visits as usual . Outcomes were measured in 4,034 persons aged 75 or 80 years old and dwelling at home .  The difference in mean total costs between the intervention and the control group discounted at 3 % was € −856 ( 95 % CI −2,455 to 744 ) in 75-year-olds and € 694 ( −2,684 to 4,071 ) in 80-year-olds . The discounted difference in mean active life-years was 0.034 ( −0.058 to 0.125 ) and 0.197 ( 0.013 to 0.380 ) , respectively . The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration
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 .