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dc.contributor.authorEaston, T.-
dc.contributor.authorMilte, R.-
dc.contributor.authorCrotty, M.-
dc.contributor.authorRatcliffe, J.-
dc.identifier.citationBMC Health Services Research, 2017; 17(1):226-1-226-15-
dc.descriptionPublished online: 21 March 2017-
dc.description.abstractBackground: Residential care infrastructure, in terms of the characteristics of the organisation (such as proprietary status, size, and location) and the physical environment, have been found to directly influence resident outcomes. This review aimed to summarise the existing literature of economic evaluations of residential care infrastructure. Methods: A systematic review of English language articles using AgeLine, CINAHL, Econlit, Informit (databases in Health; Business and Law; Social Sciences), Medline, ProQuest, Scopus, and Web of Science with retrieval up to 14 December 2015. The search strategy combined terms relating to nursing homes, economics, and older people. Full economic evaluations, partial economic evaluations, and randomised trials reporting more limited economic information, such as estimates of resource use or costs of interventions were included. Data was extracted using predefined data fields and synthesized in a narrative summary to address the stated review objective. Results: Fourteen studies containing an economic component were identified. None of the identified studies attempted to systematically link costs and outcomes in the form of a cost-benefit, cost-effectiveness, or cost-utility analysis. There was a wide variation in approaches taken for valuing the outcomes associated with differential residential care infrastructures: 8 studies utilized various clinical outcomes as proxies for the quality of care provided, and 2 focused on resident outcomes including agitation, quality of life, and the quality of care interactions. Only 2 studies included residents living with dementia. Conclusions: Robust economic evidence is needed to inform aged care facility design. Future research should focus on identifying appropriate and meaningful outcome measures that can be used at a service planning level, as well as the broader health benefits and cost-saving potential of different organisational and environmental characteristics in residential care. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) registration number CRD42015015977.-
dc.description.statementofresponsibilityTiffany Easton, Rachel Milte, Maria Crotty and Julie Ratcliffe-
dc.publisherBioMed Central-
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated-
dc.subjectSystematic review; ageing; long-term care; infrastructure; economic evaluation-
dc.titleWhere's the evidence? A systematic review of economic analyses of residential aged care infrastructure-
dc.typeJournal article-
dc.identifier.orcidRatcliffe, J. [0000-0001-7365-1988]-
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