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. 1: Randomised controlled trial
Abstract Objectives : To assess the effectiveness of a trained district nurse individually prescribing a home based exercise programme to reduce  falls and injuries in elderly people and to estimate the cost effectiveness of the programme . Design : R and omised controlled trial with one year 's follow up . Setting : Community health service at a New Zeal and hospital . Participants : 240 women and men aged 75 years and older . Intervention : 121 participants received the exercise programme ( exercise group ) and 119 received usual care ( control group )  ; 90 % ( 211 of 233 ) 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 46 % ( incidence rate ratio 0.54 , 95 % confidence interval 0.32 to 0.90 ) . Five hospital admissions were due to injuries caused by falls in the control group and none in the exercise group . The programme cost $ NZ1803 ( £ 523 ) ( at 1998 prices ) per fall prevented for delivering the programme and $ NZ155 per fall prevented when hospital costs averted were considered . Conclusion : A home exercise programme , previously shown to be successful when delivered by a physiotherapist , was also effective in reducing falls when delivered by a trained nurse from within a home health service . Serious injuries and hospital admissions due to falls were also reduced . The programme was cost effective in participants aged 80 years and older compared with younger participants
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 .