Economic Evaluation – Cost-utility analysis

[SOURCE: Glanz A and Knapp M (2017) Understanding substantive and theoretical issues in long-term care. Glossary of key terms. From: Social Protection Investment in Long-Term Care Project, HORIZON 2020 - Grant Agreement No 649565. European Union. (The resource is accessible here)]

Many decisions that need to be taken with regard to the deployment of resources raise broader questions. For example, how should resources be allocated between supporting adults with learning disabilities and older people with dementia? A cost-effectiveness analysis may not be able to help in this instance because different outcome measures would be needed for the two groups of service users. The decision-maker therefore needs a common measure of outcome that is relevant across both groups. In healthcare research, two commonly used generic measures are utility – operationalised in terms of quality adjusted life years (QALYs)  – and disability – often measured by disability-adjusted life years (DALYs).  Using this kind of generic outcome measure allows the evaluation to address more strategic issues. This type of evaluation is often called a cost-utility analysis (CUA) by health economists. In social care, there has not been an equivalent to the QALY until relatively recently, but there are now two such generic outcome constructs being used in some countries: social care-related quality of life (SCRQoL) as measured by the Adult Social Care Outcomes Toolkit (ASCOT; Netten et al. 2012) and wellbeing as measured by ICEpop CAPability (ICECAP) (Grewal et al. 2006). [See Outcome measures below.]

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