There is increasing concern over the costs of providing services and support to improve the health and independence of the nation's elderly. Interventions that may improve health are also evaluated in terms of the resources needed to do so. This research core aims to give advice and work with the other projects of the center to explore the methodological issues and problems specific to the assessment of outcomes, adherence, and costs in geriatrics and gerontology. In the assessment of outcomes and adherence, these issues include a) how to collect health status and adherence information from populations that include individuals with sensory and cognitive limitations; b) the inclusion of health states relevant to non-institutionalized and institutionalized older persons; and c) scaling properties that make some instruments less relevant to older persons. In the assessment of costs and cost effectiveness, these issues include a) how to collect costs of the many types of services delivered to older persons in a variety of settings and systems of care; b) inclusion of sometimes considerable 'out-of-pocket' health costs for services such as nursing home care; c) indirect costs incurred by family or other caregivers; and d) the valuation of preferences and utilities.
The specific aims of this research core are: 1. To provide technical support in design, statistics, and health utility and cost measurement for all the projects of the center, in particular the IS-1, IDS-2 and IS-2, and IDS-3 and IS-3 projects. 2. To assess the cost-effectiveness of proven or conjectured effective interventions of this Center; and 3. To examine new approaches to cost-effectiveness analysis in geriatrics and gerontology. By working on common measurement issues with the investigators in each of the proposed intervention studies, the proposed RRC is an efficient mechanism for advancing cost and effectiveness research in the field of geriatrics and gerontology.
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