Influenza in Nursing Homes

Excerpt

To the editor: In their article on type A influenza prevention and control in nursing homes, Patriarca and colleagues (1) express cost-effectiveness as the ratio of the net health care costs to net health effects. They should be commended for acknowledging that including the costs of continuing institutional care during years-of-life gained often biases a cost-effectiveness analysis, and disregarding these costs may be acceptable. However, they ignore a basic principle of cost-effectiveness research and later do a misleading calculation.

Direct medical costs, defined by the authors as the costs of treatment and hospitalization for those acquiring influenza, should have been