Evaluating Health Interventions for Older People

Abstract

In recent years there has been a growing emphasis on evidencebased medicine and measuring outcomes of health care. The evaluation of health interventions for older people has increasingly relied upon the use of standardized assessment instruments, which are seen as providing detailed, holistic and patient-centred information. This article argues that such an approach has several drawbacks which may have serious implications for the evaluation and provision of health care. Standardized assessment instruments ignore the social dimensions of interviewing, decontextualize scores and contain an implicitly individualistic biomedical ideology of health. These factors undermine the effective evaluation of interventions. This is particularly significant when health care is purchased on the basis of delivering demonstrable gains. Provision for older people may be under threat if methods of evaluating its efficacy are inadequate.