title: A systematic review of instruments for measuring outcomes in economic evaluation within aged care.
abstract: BACKGROUND
  This paper describes the methods and results of a systematic review to identify instruments used to measure quality of life outcomes in older people. The primary focus of the review was to identify instruments suitable for application with older people within economic evaluations conducted in the aged care sector.
  
  
  METHODS
  Online databases searched were PubMed, Medline, Scopus, and Web of Science, PsycInfo, CINAHL, Embase and Informit. Studies that met the following criteria were included: 1) study population exclusively above 65 years of age 2) measured health status, health related quality of life or quality of life outcomes more broadly through use of an instrument developed for this purpose, 3) used a generic preference based instrument or an older person specific preference based or non-preference based instrument or both, and 4) published in journals in the English language after 2000.
  
  
  RESULTS
  The most commonly applied generic preference based instrument in both the community and residential aged care context was the EuroQol - 5 Dimensions (EQ-5D), followed by the Adult Social Care Outcomes Toolkit (ASCOT) and the Health Utilities Index (HUI2/3). The most widely applied older person specific instrument was the ICEpop CAPability measure for Older people (ICECAP-O) in both community and residential aged care.
  
  
  CONCLUSIONS
  In the absence of an ideal instrument for incorporating into economic evaluations in the aged care sector, this review recommends the use of a generic preference based measure of health related quality of life such as the EQ-5D to obtain quality adjusted life years, in combination with an instrument that has a broader quality of life focus like the ASCOT, which was designed specifically for evaluating interventions in social care or the ICECAP-O, a capability measure for older people.
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, A Block, Repatriation General Hospital, 202-16 Daws Road, Daw Park, SA, 5041, Australia. bula0011@flinders.edu.au.
authors.forename: Norma B
authors.initials: NB
authors.lastname: Bulamu
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, A Block, Repatriation General Hospital, 202-16 Daws Road, Daw Park, SA, 5041, Australia. billingsley.kaambwa@flinders.edu.au.
authors.forename: Billingsley
authors.initials: B
authors.lastname: Kaambwa
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, A Block, Repatriation General Hospital, 202-16 Daws Road, Daw Park, SA, 5041, Australia. julie.ratcliffe@flinders.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000191:economics*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012946:Social Welfare / Q000191:economics*; D012959:Socioeconomic Factors