Economic evaluations of seasonal influenza vaccination for the elderly

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population | BMJ Open

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Image source: Joe The Goat Farmer – Flickr // CC BY 2.0

Objectives: The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.

Results: Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.

Conclusions: Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Full reference: Shields. G.E. et al. (2017) Systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union. BMJ Open. 7:e014847

 

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Reducing hospital admissions by improving continuity of care in general practice

This briefing summarises research that analysed data from over 230,000 anonymised patient records for older people aged 62 – 82 years | The Health Foundation

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Image source: The Health Foundation

  • Continuity of care is an aspect of general practice valued by patients and GPs alike. However, it seems to be in decline in England.
  • Our analysis, published in The BMJ and summarised in this briefing, looks at the link between continuity of care and hospital admissions for older patients in England. We looked specifically at admissions for conditions that could potentially be prevented through effective treatment in primary care.
  • We found there to be fewer hospital admissions – both elective and emergency – for these conditions for patients who experience higher continuity of care (ie those who see the same GP a greater proportion of the time). Controlling for patient characteristics, we estimate that if patients saw their most frequently seen GP two more times out of every 10 consultations, this would be associated with a 6% decrease in admissions.
  • To improve continuity for patients, general practices who are not already doing so could set prompts on their booking systems and encourage receptionists to book patients to their usual GP. Patients could also be encouraged to request their usual GP.
  • Clinical commissioning groups and NHS England Area Teams could work with general practices to support quality improvement initiatives that maintain or improve continuity of care.
  • Future national initiatives should have a well developed understanding of how and why the policy will impact on continuity in a particular context.

Read the full overview here

Read the full report here

Preventing falls and fractures

Public Health England has published Falls and fracture consensus statement: supporting commissioning for prevention.

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The guidance is aimed at local commissioning and strategic leads with a remit for falls, bone health and healthy ageing.  This document outlines approaches to interventions and activities helping prevent falls and fractures to improve health outcomes for older people.

The Royal College of Physicians has published Look out! Bedside vision check for falls prevention.

This guide aims to help ward staff assess a patient’s eyesight in order to help prevent them falling or tripping while in hospital.

Changing risk behaviours and promoting cognitive health in older adults

A summary of reviews supporting the commissioning of interventions across a range of health behaviours for older adults. | Public Health England

This resource is intended for local authority and clinical commissioning groups to identify what types of interventions they should focus on to help the uptake and maintenance of healthy behaviours and promote cognitive health among older adults living in the community.

It is also intended for providers of lifestyle behaviour change programmes to support the development of evidence-informed prevention packages for older adults.

It is produced in a way that makes it accessible to public health managers and practitioners working in the public, private and third sector.

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Image source: http://www.gov.uk