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01.12.2018 | Review | Ausgabe 1/2018 Open Access

Cost Effectiveness and Resource Allocation 1/2018

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

Zeitschrift:
Cost Effectiveness and Resource Allocation > Ausgabe 1/2018
Autoren:
Kai Huter, Katarzyna Dubas-Jakóbczyk, Ewa Kocot, Katarzyna Kissimova-Skarbek, Heinz Rothgang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12962-018-0100-4) contains supplementary material, which is available to authorized users.

Abstract

Background

In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological 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 methodological requirements are actually met in applied health economic evaluations.

Methods

Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular.

Results

Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard.

Conclusion

There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological 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.
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