You are viewing the site in preview mode

Skip to main content

Advertisement

Table 1 Synoptic table of challenges concerning the economic evaluation of health promotion activities for older people

From: Economic evaluation of health promotion for older people-methodological problems and challenges

Synoptic table of problems concerning the economic evaluation of health promotion activities for older people
To differentiate the different aspects,
 - general problems of health economic evaluations are in normal lettering;
 - aspects that arise mainly from the specific nature of health promotion are presented in italics,
 - aspects that gain special importance for older people are in bold
Societal perspective recommended (in some countries generally required)
Attribution of effects
 - Long time horizon (but shorter effective period for older people)
 - RCTs are difficult to implement
 - influence of third variables is increased;
 - Long term outcomes have to be estimated
Measuring and valuing of outcomes
 - Multiple endpoints
 - Long causal chains (use of proxy outcomes)
 - Social benefits and non-health targets gain importance
 - Intersectoral consequences
 - Diverging preference structures of older people
 - Cost-utility analysis and cost-benefit analysis may imply age based rationing
Identification, measurement of costs
 - Measurement and valuation of informal caregiver time
 - Measurement and valuation of productivity costs (including unpaid labour)
 - Costs incurred in added years of life
 - intersectoral costs
Equity considerations
Discounting of benefits reduces effectiveness results
Increased level of uncertainty
Choice of comparator is difficult
Context-sensitivity – limited transferability