From: Economic evaluation of health promotion for older people-methodological problems and challenges
Methodological options | Potential discriminatory effects for older people |
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If … | the effect will be …. |
the perspective of the study is partial, | societal benefits are underestimated; for older people e.g. reduced costs for long-term care. |
informal caregivers time and other informal care costs are excluded, | benefits of interventions that aim at the reduction of dependency on long-term care are underestimated. |
productivity costs are included without considering unpaid work, | societal value of senior’s unpaid work is neglected (informal care, volunteer work, household work). |
cost incurred in added years of life unrelated to the interventions are included, | life-prolonging interventions for older people will be rated less cost effective, because older people will produce more costs in near future due to comorbidities. |
effects are measured by natural parameters (CEA), | social benefits that are more important for older people are not covered. |
effects are measured by QALYs (CUA), | benefits of interventions for older people will be underestimated, because |
… preferences of older people, especially social benefits are not covered. | |
… a lower life expectancy results in less QALYs gained. | |
benefits are valued as monetary outcomes by willingness-to-pay (CBA), | results will be biased depending on distributive effects on the respondent, interventions for older people may be rated poorly if respondents are younger people. |
benefits are valued monetarily without subjective elements (CBA), | benefits of the intervention will be underestimated, because social benefits are especially important for older people. |