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Cost Effectiveness and Resource Allocation

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Open Access 01-12-2018 | Review

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

Authors: Kai Huter, Katarzyna Dubas-Jakóbczyk, Ewa Kocot, Katarzyna Kissimova-Skarbek, Heinz Rothgang

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2018

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.

Available only for authorised users

The National Health Service Economic Evaluation Database and the Health Technology Assessment Database via the Centre for Review and Dissemination have not been searched as they are no longer updated since 2015. The search in the databases and on websites identified 2.410 relevant citations. After removing duplicates 1.833 records were screened. Based on titles and abstracts 1.815 records were rejected. Based on full text analysis ten studies were excluded for not meeting the eligibility criteria. The most common reason for exclusion was the lack of separate outcomes for the population 65+ (six studies).

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Title: Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?
Authors: Kai Huter
Katarzyna Dubas-Jakóbczyk
Ewa Kocot
Katarzyna Kissimova-Skarbek
Heinz Rothgang
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Cost Effectiveness and Resource Allocation / Issue 1/2018
Electronic ISSN: 1478-7547
DOI: https://doi.org/10.1186/s12962-018-0100-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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