Economic evaluation of long-term care interventions: Methods challenges and solutions

Rita Faria, Helen Louise Ann Weatherly, Tony Smith, Martin Knapp

Research output: Contribution to conferenceOtherpeer-review


In many high income countries, the demand for long-term care is increasing. In this age of longevity, an increasing proportion of the population have chronic diseases and multiple morbidities. Long-term care is used to support people in many aspects of daily living such as dressing, bathing and eating, over an extended period of time and this care may delay or supplement the use of health care. Demographic and financial pressures have meant that there is a growing need to allocate resources to services within a tight budget and in a way that offers good value for money.
Economic evaluation offers an explicit and transparent framework to guide decisions on how to optimise the use of available resources given a fixed budget. Standard methods for economic evaluation in health can be difficult to apply for long-term (or social) care interventions. This session will provide an overview of the methods applied to date to assess the cost-effectiveness of long-term care, present developments in the guidance offered by the UK National Institute of Health and Care Excellence (NICE) for assessing such care, discuss the practical issues and challenges of developing relevant methods guidance and ways forward.
Our first presentation reports on a systematic review of the methods used to undertake economic evaluation of long-term care. It summarises the key methods used, it identifies the key issues and challenges, highlighting areas for further research and calling for clarity on the methods applied. Challenges in the evaluation of long-term care include clarity on the objective/s of the analysis, quantifying the benefits and costs of the interventions across sectors, accounting for the trade-offs between sectors and defining a cost-effectiveness threshold, as well as dealing with uncertainty in the evidence-base.
In the second presentation, Professor Gillian Leng will share the experience of the NICE in the development of guidance and advice for practitioners, commissioners and managers across the spectrum of health and social/long-term care. Particular attention will be given to the recently developed NICE methods guide and reference case for evaluation of social care.
Finally, Professor Martin Knapp will illustrate issues and challenge encountered in the economic evaluation of long-term care with a selection of applied case studies. These case studies exemplify how to address the challenges faced whilst providing a message to support decision making and the needs of policy-makers.
The session will then be open to debate between the presenters and the audience. The presenters are leading experts in evaluating long-term care to inform decision making. Key questions include how best to evidence the benefits of these interventions for individuals receiving long-term care, the trade-off between these benefits and the additional costs, the multi-sector nature of long-term care and how best to make decisions in this difficult context. The audience will gain an understanding of the key issues facing analysts in the economic evaluation of long-term care interventions and how to undertake useful evaluations for informing future decision-making, as well as being able to shape this debate. 
Original languageEnglish
Publication statusUnpublished - 2014
EventInternational Health Economics Association (iHEA) 2014 - Dublin, United Kingdom
Duration: 13 Jul 201416 Sept 2014


ConferenceInternational Health Economics Association (iHEA) 2014
Country/TerritoryUnited Kingdom

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