Economic evaluation of health promotion and primary prevention actions for older people-a systematic review

Background: Healthy ageing and health promotion (HP) actions for older people have become an important health sector priority. At the same time, the application of economic evaluation methods in the field of health interventions in order to support allocative decision processes is of growing importance. The aims of the review were to analyze what the existing evidence is on cost-effectiveness of HP and/or primary prevention (PP) programmes for older people whilst providing deeper insight into methodological aspects of such studies, their overall quality and issues related to practical implementation of results. Methods: Systematic review of contemporary evidence (2000-15). Studies' eligibility criteria included target population 65 years old or older; interventions classified as HP or PP; a full economic evaluation conducted. The search strategy included five electronic databases and Internet websites of institutions or projects related to the topic. Quality assessment of the studies was based on the 'Drummond checklist'. Results: After screening 6450 records, 29 papers were included, the vast majority of which (22) focus on fall prevention strategies. In this area, there are examples of good and moderate quality studies which confirm the cost-effectiveness of diverse physical activity interventions in fall prevention. The existing studies are characterized by huge differences in the methods applied as well as overall quality which limits the comparability and generalizability of the results. Conclusions: There is a need for development and implementation of economically driven studies, with methods adjusted to particular character of HP and/or PP strategies for older population.