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 the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability.
BACKGROUND Losing the ability to walk safely and independently is a major concern for many older adults . The Lifestyle Interventions and Independence for Elders study recently demonstrated that a physical activity ( PA ) intervention can delay the onset of major mobility disability . Our objective is to examine the re sources required to deliver the PA intervention and calculate the incremental cost-effectiveness compared with a health education intervention . METHODS The Lifestyle Interventions and Independence for Elders study enrolled 1,635 older adults at risk for mobility disability . They were recruited at eight field centers and r and omly assigned to either PA or health education . The PA program consisted of 50-minute center-based exercise 2 × weekly , augmented with home-based activity to achieve a goal of 150 min/wk of PA . Health education consisted of weekly workshops for 26 weeks , and monthly sessions thereafter . Analyses were conducted from a health system perspective , with a 2.6-year time horizon . RESULTS The average cost per participant over 2.6 years was US$ 3,302 and US$ 1,001 for the PA and health education interventions , respectively . PA participants accrued 0.047 per person more Quality -Adjusted Life-Years ( QALYs ) than health education participants . PA interventions costs were slightly higher than other recent PA interventions . The incremental cost-effectiveness ratios were US$ 42,376/major mobility disability prevented and US$ 49,167/QALY . Sensitivity analyses indicated that results were relatively robust to varied assumptions . CONCLUSIONS  The PA intervention costs and QALYs gained are comparable to those found in other studies . The ICERS are less than many commonly recommended medical treatments . Implementing the intervention in non- research setting s may reduce costs further
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 .