Critical appraisal of published economic evaluations of home care for the elderly.
The goal of the study was to appraise the economic evaluations published between 1980 and 2004 of "home care" for the elderly, focusing on the methodological aspects. MEDLINE was searched to identify and assess economic evaluations (defined as an analysis comparing two or more strategies, involving the assessment of both costs and consequences) related to "home care" exclusively for the elderly (65 years or more) and to critically appraise the methodology using five accepted principles used worldwide for conducting economic evaluations. Twenty-four economic evaluations of "home care" for the elderly were identified and the articles were assessed. All five principles were satisfactorily addressed in two studies (8.3%), four principles in four studies (16.7%), three principles in five studies (20.8%), two principles in eight studies (33.3%) and only one principle in five studies (20.8%). A disparity in the methodology of writing economic evaluations compromises the comparisons among outcomes and lately jeopardizes decisions on the choice of the most appropriate healthcare interventions. The methodological principles represent important guidelines but the discussion of the context of the economic evaluation and the special characteristics of some services and populations should be considered for the appropriate use of economic evaluations.
Ramos
Maria Lucia Teixeira
ML
São Luiz Hospital, R.Traipú, 568 ap. 131, Pacaembu, São Paulo, SP, CEP 01235-000, Brazil. mlramos@terra.com.br
Ferraz
Marcos Bosi
MB
Sesso
Ricardo
R
D000368:Aged; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D006299:Health Services for the Aged / Q000191:economics*; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D016239:MEDLINE