title: [Cost-effectiveness research in elderly residents in long-term care: prevention is better than cure, but not always cheaper].
abstract: Cost-effectiveness research in elderly residents in long-term care facilities is based on general principals of cost-effectiveness research; these have been developed primarily from the perspective of relatively healthy adults in curative medicine. These principals are, however, inadequate when evaluating interventions for the fragile elderly in long-term care, both in terms of the value attached to the health of patients and to the specific decision-making context of the institution. Here we discuss the pitfalls of cost-effectiveness research in long-term care facilities, illustrated by two prevention interventions for prevalent conditions in nursing homes: pressure ulcers and urinary tract infections. These turned out to be effective, but not cost-effective.
authors.affiliation: LUMC, Leiden.
authors.forename: Wilco P
authors.initials: WP
authors.lastname: Achterberg
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Wilbert B
authors.initials: WB
authors.lastname: van den Hout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006801:Humans; D008134:Long-Term Care / Q000191:economics*; D009735:Nursing Homes / Q000191:economics*; D003668:Pressure Ulcer / Q000191:economics / Q000517:prevention & control; D015995:Prevalence; D011315:Preventive Medicine / Q000191:economics*; D014552:Urinary Tract Infections / Q000191:economics / Q000517:prevention & control